Health Care Reform

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What is Health Care Reform?

In March of 2010, the Patient Protection and Affordable Care Act (ACA) was signed into law for the purpose of making health insurance more accessible and affordable, and to improve the quality of health coverage for all Americans.

As part of the new rights and protections offered to consumers, the health care law will require health insurance companies to cover individuals with pre-existing health conditions and require all plans to offer 10 essential health benefits. You can read more about these changes and more at healthcare.gov.

Another key component of health care reform is to provide a marketplace, or exchange, where individuals can compare health insurance plan options side-by-side, including costs and benefits, and pick the one that best meets their budget and health needs.

What is the Health Insurance Marketplace?

The Health Insurance Marketplace (and state marketplaces and exchanges) allows you to look at health insurance options based on your household size, income and location. By providing this information, you’ll be able to see if you qualify for financial assistance to lower costs on monthly premiums or out-of-pocket costs.

  >> Learn more about the Health Insurance Marketplace

Will the Health Insurance Marketplace Affect FEHBP?

A recent notice received from the U.S. Office of Personnel Management (OPM) stated that the Federal Employees Health Benefits Program (FEHBP), in which MHBP participates, “is not affected by the health exchanges” (also known as the Health Insurance Marketplace).
 
Subsequent notices from OPM announced that FEHBP meets the requirements for minimum essential coverage (MEC) under the new health care reform law.  This means your benefits include the essential health coverage outlined in the Affordable Care Act and you won’t have to make a payment to the Internal Revenue Service (IRS) for non-compliance.  OPM also verified that FEHBP satisfies the minimum value standard.  This means that your health plan's share of the total allowed benefit costs covered by the plan is no less than 60 percent (actuarial value) of such costs.

As an MHBP member, we want to make sure that you understand that you are not required to participate in the health exchanges.  However, you are free to evaluate the Marketplace at www.healthcare.gov.  If you plan to check out the Marketplace, there are important considerations as it relates to your FEHBP coverage, such as those shared in a recent notice from the OPM:
 

“Please be aware that there is no government or employer contribution to the premiums for Health Insurance Marketplace plans.  Also, premiums are paid on an after-tax basis for Health Insurance Marketplace plans. In addition, [OPM wants employees to know that] if they are eligible to enroll in the FEHB Program but they do not enroll or if they cancel their FEHB enrollment, they should be aware of the consequences of such actions including the following but not limited to: If an employee dies, he/she will not have an FEHB Self and Family enrollment for his/her survivors to continue, even if he/she is eligible for a survivor annuity.  If an employee retires, he/she will not have an FEHB enrollment to continue into retirement.”

Please note:  Although care has been taken to ensure the accuracy, completeness and reliability of the information provided, MHBP assumes no responsibility therefore. The user of the information agrees that the information is subject to change without notice, and the most up-to-date information regarding federal health insurance plans, policies or procedures should be acquired via the appropriate hiring authority and/or via the US Office of Personnel Management. MHBP assumes no responsibility for the consequences of use of such information, nor for any infringement of third party intellectual property rights which may result from its use.

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