On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act (PPACA) which revised by the House Reconciliation Bill that was signed into effect on March 30, 2010.

With this new law, the employer based system of providing healthcare to employees is maintained. There is NOT a public plan and individuals will be required to have coverage by 2014.

While this law makes several positive changes, the focus is more on health insurance reform than health care reform as it fails to address many of the underlying factors which continue to contribute to the skyrocketing cost of healthcare.

At the present time, we do not have a lot of detail with regards to the definitions of certain provisions as well as the method for implementation.

So what does this mean for you? Here is a summary of the timeline of the items (not all inclusive) that will affect you— (for more detailed information, please visit our website and select healthcare reform)

Effective immediately:

• New federal rate review process is established
• State grants to establish ombudsman programs are awarded
• National risk-pool is created 90 days from enactment
• Temporary retiree reinsurance program is established
• Small business tax credit is established

Effective on or after 10/1/2010:

• Lifetime benefit maximums are prohibited
• Cost sharing or caps on preventive benefits are eliminated.
• Coverage for dependents up to age 26 is mandated (married child can be a dependent)
• Eliminates pre-existing condition exclusions for dependent children under age 19
• Allows for restricted annual limits on essential benefits (as determined by Department of Health & Human Services HHS)
• New health plan disclosure and transparency requirements are created
• $250 rebate for Medicare participants falling into Rx donut-hole

Effective on or after 1/1/2014:

• Health Insurance Exchange is created
• Guarantee issue is required
• Rating restrictions are imposed for factors such as age, area, family composition and smoking status
• Individual and Employer requirements are established
• Pre-existing condition exclusions are eliminated
• Waiting periods for coverage are limited to 90 days
• An essential health benefits package is established that provides a comprehensive set of services.
• States are allowed the option to merge the individual and small group markets.

Source—“Healthcare Reform Implementation Timeline” – Kaiser Family Foundation, 3/31/2010

Lunch & Learn Seminars Coming Soon!

Beginning in May, we will be hosting lunch & learn seminars to help you better understand the impact of this new legislation. Watch your email for a list of dates and times.

These will be free seminars and a brown bag lunch will be provided.

Check our website frequently for updates and availability as space will be limited.

Key Changes to Medicare Part D Drug Benefit Coverage Gap

One of the most beneficial components of the new PPACA law is that over time, it will reduce the amount that Medicare Part D enrollees will have to pay for prescription drugs when they fall into the “coverage gap.” The coverage gap in 2010 is $3,610 and approximately 14% of all enrollees reach this coverage gap.

Beginning in 2011, the new reform law will reduce the amount that Part D enrollees are required to pay for their prescriptions when they reach the gap.

2011— a 50% discount of the total cost of brand name drugs in the gap, as agreed to by pharmaceutical manufacturers.

Over time, Medicare will gradually phase in additional subsidies in the coverage gap for brand-name drugs (beginning in 2013) and generic drugs (beginning in 2011).

We Have Moved!

We have a new home! As of April 1st, we have re-located to the Burnham Drive Professional Plaza.

Our new address is:

11505 Burnham Drive NW, Suite 101
Gig Harbor, WA 98332.

Our phone, fax, email and mailing address remain unchanged.