With the passage of the Patient Protection and Affordable Care Act in March 2010, the landscape of health care in the United States will undergo many changes over the next several years. The Early Retiree Reinsurance Program (ERRP) is the first issue that LIUNA health and welfare funds will have to consider.
This program will provide an 80 percent subsidy to plans for retiree claims of between $15,000 and $90,000 for retirees who are over age 55 and not yet eligible for Medicare. Congress has appropriated funding of $5 billion for the temporary program which was effective June 1, 2010, and will end the earlier of when the funds run out or January 1, 2014.
The U.S. Department of Health & Human Services (DHHS) has released the application instructions and forms for the ERRP. They are available at Regulations and Guidance on the Department’s website.
The Departments of Health and Human Services, Labor, and Treasury are beginning to release new regulations for the numerous provisions of the legislation, most recently the “Grandfathering Rules” for employer-based plans. However, there are certain benefits that LIUNA’s health and welfare plans must provide for plan years starting on or after September 23, 2010 (January 1, 2011, if a calendar-year plan), notably:
- Lifetime limits or maximums may not be applied to benefits.
- Plans that provide dependent coverage must extend coverage to adult children up to age 26 if the children do not have coverage available through an employer (beginning in 2014, adult children can continue on their parents’ coverage until age 26 regardless of availability of coverage).
- No plan may exclude coverage for pre-existing conditions for children under age 19.
Because the impacts of health care reform will be so broadly felt, the LHSFNA is extending its coverage of the topic. It will be a regular feature in each issue of LIFELINES. In addition, as new regulatory provisions become available, information will be provided on the LHSFNA’s website under the new section, Health Care Reform Updates. If you do not currently subscribe to LIFELINES ONLINE, you may sign up for the free monthly publication and Update at the Fund’s Subscription page, or you may contact the Fund at 202-628-5465 to receive the latest updates as they are posted.
[Mary Jane MacArthur is the Fund’s Health Promotion Division Director.]