Health Care Reform Legislation – 2012

Our friends at Hawkins, Ash, Baptie & Company, Tax Advisors & CPA’s have published a great chart showing the impacts of the health care reform legislation.

Today’s focus:   2012

All group plans and group and individual health insurers (including self‐insured plans) will have to provide a summary of benefits and a coverage explanation that meets specified criteria to all enrollees when they apply for coverage, when they enroll or reenroll in coverage, when the policy is delivered and id any material modification is made to the terms of their coverage. The summary and explanation can be provided
electronically or in written form, and it must be no more than 4 pages in length with print no smaller than 12 point font written in a culturally linguistically appropriate manner. There is a $1000 per enrollee fine for willful failure to provide the information.

All group plans (including self‐insured plans) and all individual and group carriers will have to annually submit reports to the Secretary of DHHS on whether or not the benefits provided under their plans meet criteria to be established by DHHS on improving health outcomes, preventing hospital readmissions, improving patient safety and reducing medical errors, and include wellness and health promotion activities. This report also must be provided to all plan participants during the annual open enrollment period and DHHS will make the reports public available through the Internet. The Secretary of DHHS can also create and impose fines for noncompliance by employers and plans.

Coming tomorrow:  2013