2010-09-01

KTB's Health Care Reform Tools and Resources

*Any questions or specific requests should be directed to reform@ktbenefits.com*

KTB’s Health Care Reform Task Force has created resources and will continue to develop tools and additional resources for our clients and brokers to use as they weather the changes.  This page will be updated continuously as new information and resources are available.

BREAKING NEWS

9/1/10:  A model employee notice to use when notifying employees of the enrollment opportunity for dependents under age 26 who previously aged out of coverage is now available in the Reform Library.  These dependents must be provided a 30 day enrollment opportunity when the plan renews after 9/23/10, which can coincide with the employer's open enrollment period.

8/19/10: New Jersey Small Employer Health Plan Board issues requirements for coinsurance and maximum out-of-pocket payment credits following plan option withdrawals!

 8/13/10: High risk pool information now available for PA and NJ. Delaware is participating in the federal program. Information regarding the high risk pool programs in PA, NJ and the federal program, including applications for those programs, are now available.  Summaries of these programs can be found in the Reform Library below.  Additional information can be found online at http://www.pafaircare.com/ for PA, at http://www.state.nj.us/dobi/division_insurance/njprotect/index.htm for NJ, and www.pcip.gov for federal.

8/2/10: Model language to be used by grandfathered health plans to satisfy the disclosure notice requirements is available in the Reform Library.  The language can be used separately and should be incorporated into any summary plan descriptions, plan documents, open enrollment materials, and anywhere else that discusses the terms of any benefits affected.

CLIENT SEMINAR 9/23/10:

A Strategic Look at Health Care Reform!

KTB will host a client seminar on September 23rd at our corporate office in Berwyn, PA for our clients, from 9:00 a.m. to 11:00 a.m. 

We will feature Jonathan Segal, Esq. of Duane Morris to discuss reform as it relates to employers, and Lori Rothschild from the UnitedHealthcare Health Care Reform Implementation Team to provide the carrier's perspective on reform. 

Invitations out soon!

REFORM LIBRARY

1. Broker Toolkit
2. Action Plan 
3. Summary and Timeline
4. Appeals Process Updated September 1st!
5. CLASS Act Limited Long-Term Care Coverage 
6. Dependent to Age 26 Model Open Enrollment Notice Added September 1st!
7. Health Care Reform: Dependent to Age 26 Carriers Extending Coverage Early
8. Dependent to Age 26 Coverage DOL Fact Sheet
9. Dependent to Age 26 Early Extension Sample Employee Memo Template
10. Dependent to Age 26 IRS Notice 2010-38 Tax Treatment of Benefits Provided with Respect to Children Under Age 27
11. Early Retiree Reinsurance HHS Fact Sheet
12. Early Retiree Reinsurance Program
13. Early Retiree Reinsurance Program Application FAQs
14. Early Retiree Reinsurance Program Application Instructions
15. Early Retiree Reinsurance Program Application Submission Do's & Don'ts
16. Early Retiree Reinsurance Program OFFICIAL Application
17. Grandfathered Health Plans
18. What it Means to be a Grandfathered Plan
19. Grandfathered Health Plans Model Disclosure Notice
20. High Risk Pool: NJ Protect 
21. High Risk Pool: PA Fair Care Fact Sheet 
22. High Risk Pool: PA Fair Care Summary 
23. Lactation Accommodation
24. Lactation Accommodation DOL Fact Sheet Added
25. Lactation Accommodation Sample Policy
26. NJ Small Employer Health Plans Coinsurance and Max Out of Pocket Credit
27. Non-Discrimination Rules
28. Preventive Services Requirements for Plans Starting After September 23, 2010
29. Preventive Services Requirements HHS Fact Sheet
30. Preventive Services Requirements Summary
31. Small Business Health Care Tax Credit IRS Eligibility Worksheet
32. W-2 Reporting Requirement

OTHER RESOURCES

The following websites also provide valuable information and resources:

• HealthCare.Gov - Government web portal to aid individuals and businesses in learning about their health care and coverage options.
• IRS Affordable Care Act Tax Provisions- includes information on the Small Business Health Care Tax Credit as well as Health Coverage for Older Children
• U.S. Department of Health and Human Services
• NJ Protect (High Risk Pool for New Jersey)
• PA Fair Care (High Risk Pool for Pennsylvania)
• Pre-Exixting Condition Insurance Plan (Federal High Risk Pool - DE participates in the federal plan)

The Patient Protection and Affordable Care Act (PPACA, as amended by the Health Care and Education Act) provides for the grandfathering of existing health insurance plans. Use our Grandfathering Tool to help determine if a plan is Grandfathered.

Dedicated Sales and
Administrative Support

Kistler Tiffany Benefits (KTB) recognizes that a strong, lasting relationship with your client is the number one priority. To assist, KTB is at your side from the first quote, to closing and beyond. Since 1972, KTB has been providing brokers with unparalleled service and support. Whether it's fast, accurate quoting, assistance in customizing a benefit package or following up on claims issues, KTB will be available to meet your needs. Our success is tied to your success.