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Ameritas Group supports the goals of Health Care Reform: expanding coverage and access to health care for all Americans, improving the quality of care, and lowering escalating costs. To find out more, use the Quick Links on the left.
Overview
The Patient Protection and Affordable Care Act and the Reconciliation Act of 2010 (referred to together as "ACA") became Federal law on March 23, 2010. Ameritas Life Insurance Corp. remains committed to complying with all applicable requirements.
The law is geared toward comprehensive medical benefits, and many market reforms affecting medical benefits are already in effect. Dental and vision benefits, when sold in a stand-alone policy of insurance, are considered HIPAA excepted benefits. That means dental and vision benefits are largely not directly affected by the initial market reform requirements.
The eagerly awaited rulings by the United State Supreme Court were issued June 28, 2012. In essence, the Affordable Care Act (ACA) was upheld. The most controversial section of the law, the Individual Mandate, was upheld through recognition of the penalty for not having Minimum Essential Coverage as a tax, and thus valid under the taxing power of Congress. The requirement for states to accept Medicaid expansion or lose existing federal Medicaid funding was struck down. This adds another component of state variability to implementation of ACA. States can now decide:
-Whether to create a state Exchange, or participate in a regional or Federally Facilitated Exchange (FFE)
-The governance structure of a state Exchange, as well as funding mechanism, contracting model and various administrative functions
-The state's benchmark plans for Essential Health Benefit Packages
-Whether to expand Medicaid eligibility
Starting in 2014, individuals and small businesses must be offered "Qualified Health Benefit" packages. These benefit packages are plan designs that require coverage for certain procedures (called "essential benefits") as will be determined by each individual state and the Federal government. Individual states may include benefits in addition to the Federal guidelines. Pediatric dental and vision benefits are included as required essential benefits, although the specific services to be covered and the coverage age for children has yet to be defined and may vary state to state and within the Federal exchange.
These Qualified Health Benefit packages must be offered both inside the Exchanges and in the private marketplace. Exchanges are marketplaces where individuals and small employers can purchase benefits and have access to premium subsidies and cost-sharing reductions. These Exchanges will be developed by the states or by the Federal government; an individual state can decide to implement their own exchange, become part of a regional exchange consisting of many states, or join the Federal exchange.
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