The federal Affordable Care Act (ACA) has mandated a number of comprehensive consumer protections to insurance plans for individuals and small employers beginning January 1, 2014. As a result, some insurance companies may be discontinuing older health plans that no longer meet the minimum requirements of the ACA and will move policyholders into new plans. The information below applies to both individual and small group plans unless otherwise noted.
Under federal law a health insurer is permitted to discontinue a plan if it provides policyholders with 90 days of advance notice and offers to transition the policyholder to another plan that it does offer.
Beginning in 2014, consumers will have more robust coverage under the ACA. Insurance companies cannot refuse to issue a policy or charge more because of a pre-existing condition. There are no co-pays or out-of-pocket costs for a number of preventive services, a benefit that many policyholders will have for the first time.
A policyholder has several options should his or her carrier opt to discontinue a plan:
Accept the replacement plan offered by the carrier.
Consider other plans offered by the carrier
Consider shopping for plans offered by other carriers
Consult an insurance agent who can help explain choices and make recommendations
Consider shopping for plans through Access Health CT, the state-sponsored health insurance exchange and only entity in the state where eligible consumers can receive federal subsidies to purchase insurance. Contact Access Health CT on the Web at www.accesshealthct.com
or phone 1-855-805-4325.
It is important for all policyholders to remember that coverage is in place though the 90-day notice period and that there is time to carefully evaluate all options.
Jan. 1, 2104 change specific to small businesses: Beginning January 1, 2014, sole proprietors, whose only employees include the sole proprietor or family member, must purchase a plan through the individual market. The Affordable Care Act (ACA ) preempts Connecticut state law which earlier had permitted a sole proprietor in this situation to purchase small group coverage.