Health plans under greater scrutiny

WASHINGTON, D.C. - The Department of Health and Human Services (HHS) on Dec. 9 released new guidance that will give consumers more information about their health insurance plan.Under the new rules, health insurers offering "mini-med" plans must notify consumers in plain language that their plan offers extremely limited benefits and direct them to where they can get more information about other coverage options. HHS has also issued guidance restricting the sale of new mini-med plans except under very limited circumstances. "The Affordable Care Act is giving consumers more control over their health care by providing them with information about their health insurance options", said Secretary Kathleen Sebelius. "Now, we're taking an unprecedented step to ensure consumers are informed when they purchase policies that offer limited coverage". The Affordable Care Act will end limited-benefit health insurance plans, sometimes called "mini-med" plans, in 2014 and provide Americans with affordable, high-quality coverage options, HHS officials said. Today, mini-med plans are often the only type of private insurance available to some workers. In order to protect coverage for these workers, HHS has issued temporary waivers from rules restricting the level of annual limits to some group health plans and health insurance issuers. Waivers only last for one year and are only available if the plan certifies that a waiver is necessary to prevent either a large increase in premiums or a significant decrease in access to coverage. Guidance issued Thursday ensures that consumers in plans with low annual limits are notified of the quality of their health plan so that they can make informed decisions about whether mini-med coverage is right for them, authorities said. The supplemental guidance requires health plans with waivers to tell consumers if their health care coverage is subject to an annual dollar limit lower than what is required under the law. Specifically, the notice must include the dollar amount of the annual limit along with a description of the plan benefits to which the limit applies. Additional guidance issued Thursday also provides new rules on when mini-med plans can continue to be sold. Under limited circumstances, insurers that have obtained a waiver of the annual limit requirement can sell policies to new employers and individuals. The Affordable Care Act bans annual dollar limits beginning in 2014. Until then, annual limits are phased out under HHS regulations published in June 2010. For plan years starting between September 23, 2010 and September 22, 2011, plans may not limit annual coverage of essential health benefits such as hospital, physician and pharmacy benefits to less than $750,000. The restricted annual limit will be $1.25 million for plan years starting on or after September 23, 2011, and $2 million for plan years starting between September 23, 2012 and January 1, 2014.

********** Published: December 9, 2010 - Volume 9 - Issue 34