2011 OE 100-10007 : Page 2
To help you make the most informed choice for your health care coverage, here is important information about health care reform that may have an impact on your 2010 and 2011 benefits. Contact your plan administrator for information on how these changes will affect your plan. To learn more about health care reform, and how it may affect you, we encourage you to visit the government reform website at www.healthcare.gov. Health plan coverage for you and your dependents Adult children are now eligible for coverage under your group health plan up to the age of 26. This begins on the first plan year on or after September 23, 2010, as long as your plan includes dependent coverage. An adult child whose coverage or benefits ended because they reached a prior lower age limit must be given a written notice that dependent coverage is available. The notice must inform him or her of their 30-day enrollment (or re-enrollment) opportunity as well as the benefit options available to them. Employees and dependents under age 19 cannot be denied coverage because of a preexisting medical condition. Lifetime and annual limits Lifetime dollar limits will no longer be applied to essential health benefits for plan years effective on or after September 23, 2010. If you were denied coverage due to reaching a lifetime limit, you may now be eligible to enroll in the plan during a special 30 day open enrollment period. An annual dollar limit covering all essential health benefits may be applied for plan years through 2013, subject to restrictions. For plan years beginning on or after Jan. 1, 2014, no annual dollar limits can be applied to essential health benefits. Other non-dollar limits on essential health benefits, such as the number of allowable visits, may continue to apply. Lifetime or Annual limits for non-essential benefits may continue to have dollar or frequency limits as outlined in your plan. For an explanation of services considered “essential health benefits” go to www.healthcare.gov.
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