David M. Gilston Insurance Agency, Inc.

HHS issued two rules on August 1st addressing the preventive care requirements in the Patient Protection and Affordable Care Act (PPACA). The first is a proposed rule, which would require new health insurance plans to cover women’s preventive services without charging a co-payment, co-insurance or deductibles for plan years starting on or after August 1, 2012. The requirement will not apply to grandfathered plans that were in effect before the law was enacted on March 23, 2010.

Wikipedia states that the law of unintended consequences is a warning that an intervention in a complex system always creates unanticipated and often undesirable outcomes. Unfortunately, health reform has “unintended consequences” written all over it. Three specific examples include: preventive care, no pre-existing conditions for children under 19, and dependent children under the age of 26 staying on parents’ plans. I’ll focus on the first topic today: preventive care.

The DOL, HHS, and IRS jointly issued another set of FAQs (Part V) regarding implementation of the market reform provision Affordable Care Act, with topics including auto-enrollment in group health plans, summary of benefit disclosure requirements to group health plan participants, grandfathered plans, dependents to age 26 requirements, preexisting condition requirements for children in individual health policies, and value-based insurance design in connection with preventive care benefits.

Who has a question about reform? Who better to answer that question than the government? While I’m sure there are mixed responses to the second question, it’s certainly worth your while to browse through the FAQs below.

The HHS, DOL, and IRS recently issued these FAQs on the implementation of health care reform as Part II and Part III. (Part I was issued on September 20th, 2010.) For simplicity, only the questions are included below. To view the government’s response and learn what this could mean to if you have a similar situation, please visit their website.

On July 14, 2010 the IRS, DOL, and HHS jointly issued Interim Final Regulations (IFR) for implementing coverage of preventive health services. The regulations generally apply to group and individual health insurance policies with plan years starting on or after September 23, 2010 and require certain preventive services to be covered without charging a co-pay, co-insurance, or deductible when a network provider delivers the services.