Benefits » Health Insurance » The Patient Protection and Affordable Care Act
In March 2010 President Obama signed the Patient Protection and Affordable Care Act (PPACA) into Federal law. The PPACA has reformed various facets of health insurance, changing how group health plan administrators and companies alike provide health insurance to their participants.
The federal regulations identified by the enactment of the PPACA are expected to have various impacts on employee benefit plan designs, costs, and eligibilities over the course of the next four years, with the initial impacts occurring for LANL participants on January 1, 2011.
In response to health plan changes mandated by the PPACA, the LANL Benefits Office is providing the following information to assist employees with understanding the January 1, 2011 health plan changes they can expect to see and how these changes may impact their enrollment decisions during this year’s Benefits Open Enrollment period.
The PPACA has extended the eligible age limit of dependents from 23 to 26. As a result of health plan changes mandated by the PPACA, employees will be allowed to re-enroll dependents who have lost medical coverage due to turning age 23. Employees may enroll their adult children dependents during the 2011 Open Enrollment period (November 2010 for active employees). Enrollment elections made during the 2011 Open Enrollment period will be effective on January 1, 2011.
Beginning January 1, 2011, employees who participate in a Health Care Reimbursement Account (HCRA) will be impacted by regulations of the PPACA [Title IX—Revenue Provisions, Subtitle A, Section 9003(c)].
The PPACA has restricted eligible reimbursement expenses for over-the-counter medicine to prescription medication and insulin only. Employees who choose to participate in a HCRA account during the 2011 plan year will need to obtain a physician prescription for over-the-counter medications to use their HCRA allocations for reimbursement. Prescriptions will be required even if the medication is available without one.
Employees can expect more information regarding impacts of the PPACA on eligible reimbursement expenses from PayFlex in the upcoming months.
While PPACA changes began in 2010, LANL employees will not experience an impact until the next Plan Year which begins on January 1, 2011.
Because the LANL Health & Welfare plans were in effect prior to March 23, 2010 and have a new plan year that commences on the first of each calendar year the PPACA considers LANL plans to be “grandfathered” plans [Title I, Subtitle C, Part 2, Section 1251a(4), Part B(i)]. As such, employees will begin to experience the impacts of the PPACA beginning the 2011 plan year through 2014.
Notice: The information on this page is subject to change as new impacts of the PPACA law, and interpretation of those impacts on benefits, evolves. Please check back often for updates and clarifications.
