Health Care Update

Health Care Update

The Patient Protection and Affordable Care Act / PPACA (or just “ACA”), “Health Reform,” or “ObamaCare” has changed the landscape of health insurance, probably forever.

The controversial passage of the law has brought about some things that are beneficial, other things that are more challenging.

Some of the positives are:

  • Guaranteed Issue, regardless of health condition
  • No “preexisting limitations” – everything is covered immediately upon the effective date
  • Wide coverage, there are “10 Essential Benefit” categories – and they are comprehensive
  • Strong rate reduction for those in lower income brackets
  • Wellness/preventive covered at no “out of pocket” costs.

Some of the challenges are:

  • The limited time line for individuals to purchase plans (November 15 – February 15, 2015)
  • In some states, there are a limited number of insurance plans/options to choose from
  • Higher rates for those not qualifying for a rate reduction
  • Challenges posed by glitches on the Federal or State Website
  • Limited networks for Doctors and Hospitals

Typically, a true “group health insurance plan” has been very expensive, especially for smaller groups – which don’t have a large employee population that helps spread out the actuarial costs when claims occur. As a result, small groups have often experienced very significant rate increases from year to year.

The good news is that through ACA plans, strong, affordable alternatives to a small group health plan are available. For instance, recently a business in Tennessee saved more than $25,000 in premium with only four people in the group.
With the help of an experienced ACA expert, small businesses may be able to offer coverage to even your part time help at no cost to the employer.

Clay Peek is the President of Peek Performance Inc, a national leader in ACA agent training. His agency has over 4000 agents serving in over
35 states. He can be reached at: