Overview   |   Top Effects   |   Early Retiree Reinsurance   |  Links

In an effort to keep CCPOA Members informed on the ever-changing National Healthcare Reforms we have posted this page of links and information. Many of the changes affect individual insurance plans and DO NOT apply to group health care plans like those the Trust offers. If you were enrolled in an individual, family or group policy on or before March 23, 2010 and remain on the plan, the plan you purchased may now be considered "grandfathered" and may be exempt from many of the new legislated reforms.

This information is provided as a courtesy to our members.

Our members should feel confident that the Trust and its partners will keep our policies in-line with the new laws as they become active, and keep you informed as these laws affect you and your coverage.

If you have questions regarding your personal or family coverage, CALL THE TRUST.     1-800-In-Unit-6 / 1-800-468-6486

California Insurance Marketplace

The State run insurance exchange is online.
Visit Covered California website.

August 1, 2010

Important Health Reform Rights
Opportunity to enroll or re-enroll dependents under the age of 26

If you have a dependent whose coverage ended, or who was denied coverage (or was not eligible for coverage), because coverage for dependent children under the plan previously ended before they were age 26, they are eligible to enroll or re-enroll in your employer's health plan with Blue Shield.

You may request enrollment for such children who are age 23-25 during your enrollment period. Enrollment will be effective as of the first day of your employer's first plan year beginning on or after September 23, 2010, even if that results in retroactive enrollment.

For more information contact the CCPOA Benefit Trust Fund at (800) IN UNIT 6 or call Blue Shield Member Services at (800) 257-6213.

Overview

IMPORTANT UPDATE:

Do you have a child turning 23 in or who is under age 26 and you would like to re-enroll? You need to complete paperwork during Open Enrollment to enroll your 23-25 year old dependent in order to continue health, dental and vision coverage.

Active members must complete paperwork in personnel to continue coverage for their 23 to 25 year olds; Retired members should contact CalPERS or the CCPOA Benefit Trust Fund (if continuing dependent coverage in the Trust’s voluntary vision program for retired CCPOA members).

Coverage ceases at age 26.

Understanding the Affordable Care Act
On March 23, 2010, President Obama signed into law the Affordable Care Act. The law puts into place health insurance changes that the Federal Government hopes will lower health care costs, guarantee more health care choices, and enhance the quality of health care for all Americans. The Act will not be implemented all at once. Portions of the law have already taken effect. Other changes will be implemented through 2014 and beyond. To see how these changes apply to CCPOA Benefit Trust policies, return to this site regularly for the latest updates.

Top Effects

Pundits on the right and left have been reacting to passage of the legislation, but what does the bill actually mean for the average American? The Huffington Post has compiled a list of the top 18 immediate effects of the health care bill as well as some that will take effect in the first year of implementation. Remember- many of the changes affect individual insurance plans and DO NOT apply to group health care plans like those the Trust offers.

  1. Health Insurers cannot deny children health insurance because of pre-existing conditions. A ban on the discrimination in adults will take effect in 2014.  
  2. Businesses with fewer than 50 employees will get tax credits covering up to 50% of employee premiums.
  3. Seniors will get a rebate to fill the so-called "donut hole" in Medicare drug coverage, which severely limits prescription medication coverage expenditures over $2,700. As of next year, 50 percent of the donut hole will be filled.
  4. The cut-off age for young adults to continue to be covered by their parents' health insurance rises to the age 26.
  5. Lifetime caps on the amount of insurance an individual can have will be banned. Annual caps will be limited, and banned in 2014.
  6. A temporary high-risk pool will be set up to cover adults with pre-existing conditions. Health care exchanges will eliminate the program in 2014.
  7. New plans must cover checkups and other preventative care without co-pays. All plans will be affected by 2018
  8. Insurance companies can no longer cut someone when he or she gets sick.
  9. Insurers must now reveal how much money is spent on overhead.
  10. Any new plan must now implement an appeals process for coverage determinations and claims.
  11. This tax will impose a ten percent tax on indoor tanning services. This tax, which replaced the proposed tax on cosmetic surgery, would be effective for services on or after July 1, 2010.
  12. New screening procedures will be implemented to help eliminate health insurance fraud and waste.
  13. Medicare payment protections will be extended to small rural hospitals and other health care facilities that have a small number of Medicare patients.
  14. Non-profit Blue Cross organizations will be required to maintain a medical loss ratio -- money spent on procedures over money incoming -- of 85 percent or higher to take advantage of IRS tax benefits.
  15. Chain restaurants will be required to provide a "nutrient content disclosure statement" alongside their items. Expect to see calories listed both on in-store and drive-through menus of fast-food restaurants sometime soon.
  16. The bill establishes a temporary program for companies that provide early retiree health benefits for those ages 55-64 in order to help reduce the often-expensive cost of that coverage.
  17. The Secretary of Health and Human Services will set up a new Web site to make it easy for Americans in any state to seek out affordable health insurance options The site will also include helpful information for small businesses. See link below.
  18. A two-year temporary credit (up to a maximum of $1 billion)is in the bill to encourage investment in new therapies for the prevention and treatment of diseases.

Notice About the Early Retiree Reinsurance Program

You are a plan participant, or are being offered the opportunity to enroll as a plan participant, in an employment-based health plan that is certified for participation in the Early Retiree Reinsurance Program. The Early Retiree Reinsurance Program is a Federal program that was established under the Affordable Care Act. Under the Early Retiree Reinsurance Program, the Federal government reimburses a plan sponsor of an employment-based health plan for some of the costs of health care benefits paid on behalf of, or by, early retirees and certain family members of early retirees participating in the employment-based plan. By law, the program expires on January 1, 2014.

Under the Early Retiree Reinsurance Program, your plan sponsor may choose to use any reimbursements it receives from this program to reduce or offset increases in plan participants’ premium contributions, co-payments, deductibles, co-insurance, or other out-of-pocket costs. If the plan sponsor chooses to use the Early Retiree Reinsurance Program reimbursements in this way, you, as a plan participant, may experience changes that may be advantageous to you, in your health plan coverage terms and conditions, for so long as the reimbursements under this program are available and this plan sponsor chooses to use the reimbursements for this purpose. A plan sponsor may also use the Early Retiree Reinsurance Program reimbursements to reduce or offset increases in its own costs for maintaining your health benefits coverage, which may increase the likelihood that it will continue to offer health benefits coverage to its retirees and employees and their families.

If you have received this notice by email, you are responsible for providing a copy of this notice to your family members who are participants in this plan.

Health Care Reform Links


This is the link for the U.S. Government's official site detailing the new Health Care Reforms

Blue Shield Guide to Health Care Reform pdf