Health Care Reform Updates

The following Health Care Reform update is an excerpt from a Cigna communication:

2015 Marketplace Enrollment Period

Open enrollment for 2015 will begin on November 15, 2014 and end January 15, 2015

2015 Maximum Annual Out-of-Pocket Limits

“The 2015 maximum annual out-of-pocket limits for all non-grandfathered plans will increase to $6,750 for individual coverage and $13,500 for family coverage.  The maximum deductibles will increase to $2,150 individual and $4,300 family for insured non-grandfathered small group plans.  For standalone child dental plans, the annual out-of-pocket maximum will be limited to $300 for one covered child and $400 for two or more children.”

Meaningful Difference

A plan offered on the federal Marketplace must be “meaningfully different” from all other plans offered by the same insurer in the same service area and metal level.  Meaningful difference requires that a consumer would be able to identify two or more material differences between plans in factors such as cost-sharing, provider networks and covered benefits.

Patient Safety Standards

Plans offered on the Marketplace must meet certain patient safety standards.  The initial standards will require that hospitals mee the Medicare Hospital Condition of Participation requirements related to quality assessment, performance improvement and discharge planning.