CID: Health Care Reform

Health Care Reform

The federal Affordable Care Act, was signed into law on March 23, 2010. The law provides for a number of new consumer protections and while many provisions have already gone into effect, most consumer protections become effective January 1, 2014. Insurance companies can no longer refuse to insure someone because of a pre-existing condition. Other protections include no lifetime limits on certain benefits, no out-of-pocket costs for preventive and wellness services. Some consumer may also qualify for tax credits and lower premiums by shopping through Connecticut’s state-based exchange – Access Health CT. The Insurance Department has provided many resources below to help all consumers understand their options and the law’s impact on their health insurance plans.


 ACA Consumer Alerts & Tips

Consumer Alert:
Consumer/Provider Alert on Affordable Care Act Changes
To Connecticut’s Autism Spectrum Disorder
And Early Intervention Services (Birth to Three) Mandates


The purpose of this Consumer Alert is to clarify Connecticut's mandated coverage for autism spectrum disorders and early intervention services as a result of changes brought about by the federal Affordable Care Act (“ACA”) to individual and small employer plans in Connecticut. 

For consumers covered under large employer plans (50 or more employees), please contact your employer or insurance company for specific information about coverage under your plan.


Summary

The ACA prohibits annual dollar limits on essential health benefits, which includes the autism mandates. Connecticut law has allowed for dollar limits but now is preempted by the ACA requirements. As a result, insurance companies are permitted to substitute the dollar limits with non-dollar limits such as hours or units of service providing those non-dollar limits are actuarially equivalent to the dollars amounts in Connecticut statutes. Insurers must notify their policyholders of all substitutions in limits for autism spectrum disorders or early intervention as a result of the ACA changes. (read more....)


Need Assistance?

Please contact the Insurance Department Consumer Affairs Division at 860.297.3900 or cid.ca@ct.gov with any questions.



Previous Consumer Alerts & Tips


How the ACA reforms the way insurance is priced:
Insurance Department Legislative Presentation on Rate Reforms

Department updates Legislature’s Insurance & Real Estate Committee on 2014 rating reforms

{Ask Question}
Questions or Complaints?
Contact the Department's Consumer Affairs Unit

By Phone: 800-203-3447 or 860-297-3900
By E-mail: cid.ca@ct.gov

Where Can I Buy Insurance?

In Connecticut, consumers can purchase insurance from the state Exchange - Access Health CT, the only marketplace that offers federal tax credits for eligible applicants.

{Access Health CT}
Click the icon or call:
1-855-805-HEALTH
(1-855-805-4325)
Outside the Exchange, consumers in Connecticut can choose from:
Other Healthcare Resources (based on income eligibility):

Essential Health Benefits (EHB):
What is covered under the ACA?
Beginning January 1, 2014,insurance plans must have the following EHBs:
  • Ambulatory Patient Services
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health, substance abuse disorder services
  • Prescription drugs
  • Rehabilitative and daily assistance services and devices
  • Laboratory services
  • Preventive, wellness services, chronic disease management
  • Pediatric services, including oral and vision care

ACA Implementation Timeline - An interactive calendar



Content Last Modified on 4/21/2014 3:17:54 PM