Health Insurance and You!

Today, August 1, two major provisions of the 2010 health reform law that affect people in the private insurance market are set to take place, according to an article by Louise Radnofsky of the Wall Street Journal. And both of these measures will save consumers money – hundreds of dollars, in some cases.

The law’s medical loss ratio rule stated that each year, health insurance companies had to spend at least 80% of revenue from premiums on actual health expenses or improving the quality of care. For large employers, that standard goes up to 85%. If, in a given year, health and quality improvement costs did not add up to that percentage, insurers could refund the extra money to consumers (or their employers) as rebates at the end of the year. While many insurance companies already met this threshold, this was the first year it was legally binding. By the end of today, a total of $1.3 billion in rebate checks, which averages out to $127 per customer, will be sent out.

The other major provision taking effect today is of particular importance for women. Starting today, people who are newly enrolled in an insurance plan will be covered for birth control and other women’s health services without a co-payment or other fees. For those already enrolled in a plan, the requirement will take effect when the next cycle begins – usually January 1. Federal officials estimate that 47 million teens and women between 15 and 64 will be eligible for this coverage, though it’s uncertain how many will take advantage of it. In addition to contraception and contraceptive counseling, the requirement covers the morning-after pill (Plan B); sterilization; supplies and support for breastfeeding; and screenings for gestational diabetes, HPV infection, HIV infection, and domestic violence.

Readers, how do you expect these new requirements to affect you and your health?

For more information, see related blog posts:

• Apr. 27, 2012: Insurers Award $1.3 Billion in Rebates to Customers
• Mar. 2, 2012: Senate Upholds Contraception Coverage Requirement for Employers
• Aug. 1, 2011: Ending Out-of-Pocket Costs for Birth Control, Breast Exams, and More