For three years, insurance providers across the nation have been working to make sure the transition to the Affordable Care Act was a smooth one. As we all know, it wasn’t, and now insurance providers and consumers have another change to deal with.
On Nov. 14, Pres. Barack Obama gave states the option to allow their insurance companies to let customers keep their health plans that otherwise would be canceled for not complying with the Affordable Care Act. Tuesday, the South Dakota Department of Labor and Regulation announced that Avera, Sanford, and DAKOTACARE, all who are approved to offer plans on the marketplace, can extend those policies that were supposed to end in January.
“So no one is going to get their coverage canceled, this gives them another year to try and sort things out and find which one is best for them,” CEO of DAKOTACARE Kirk Zimmer said.
Zimmer said 4,000 insurance holders at DAKOTACARE initially were told they would have to find new policies.
“So as an insurer, what it meant was as of Jan. 1, 2014, we weren’t planning on selling a lot of these policies anymore,” Zimmer said.
The Affordable Care Act states that a health plan must cover at least ten specific services. The policies that were going to be canceled didn’t cover all of the required benefits. The biggest change too many plans will be the addition of coverage to pediatric dental and vision care as well as mental health services. A plan must have the requirements, even if the policy holder doesn’t need all of the benefits.
Lisa Carlson is the Director of Planning and Regulation for the Sanford Health Plan said, “We’ve now given them a richer benefit package, but they didn’t want, nor did they need some things.”
Carlson said 2,500 members will be getting another letter in the mail telling them they can keep their old policies without the extra benefits, but their rates might be higher.
Debra Muller, Chief Administrative Officer for Avera Health Plans worries about her policy holders not fully understanding all of the changes.
“Right now what this really means for us is that we need to educate our small groups and individuals on what does this mean,” Muller said.
Muller said for the 400 people that have an Avera Health Plan, it’s been a 24 hour race to make sure they know about the change.
“We just want people to have health care coverage, and good coverage at that,” Muller said.
Those affected can still buy a new policy that is compliant with the ACA, if they chose not to; their old policy will be good until 2015.
Date: November 27, 2013