Women’s Preventive Services
Starting Aug. 1, 2012, new regulations concerning preventive benefits for women will take effect. While implementation of this new order is still being developed, it is important to know that most non-grandfathered health insurance plans will be subject to these new coverages immediately upon renewal beginning Aug. 1, 2012.
These additional services cover many new benefits for women without any co-pay, coinsurance or deductible (“first dollar coverage”). Some FDA-approved methods of contraception and sterilization, which includes the Plan B emergency contraceptive pill (the “morning after pill”) and tubal ligation are included in the newly required coverage.
This regulation applies to both non-grandfathered individual and group plans. Grandfathered individual policyholders and groups will be exempt as long as they maintain grandfathered status.
As of today, if an employer is a charity or hospital that has a religious objection to providing contraceptive services as part of their health plan, the insurance company (not the hospital or charity) will be required to offer the woman contraceptive care at no charge. The result is that religious organizations will not have to pay for these services and no religious institutions will have to provide these services directly. As defined by HHS, a religious employer is an organization that has the inculcation of religious values as its purpose, primarily employs and serves people who share its religious tenets, and is a nonprofit organization under sections of U.S. law that refer to “churches, their integrated auxiliaries, and conventions or associations of churches” and to “the exclusively religious activities of any religious order.”
We will issue a more comprehensive statement when we have finalized the changes.
Blue Cross Continues to Keep the Dependent Age at 26
The state of Louisiana recently passed House Bill 462, lowering the dependent age requirements for some benefits. However, Blue Cross and Blue Shield of Louisiana, and its subsidiaries HMO Louisiana, Inc. and Southern National Life Insurance Company, Inc., are excited to announce that we are not lowering our dependent age limit requirements. We will continue to offer coverage up until the age of 26.
Essential Health Benefits
On Dec. 16, 2011, the Department of Health and Human Services (HHS) issued a bulletin outlining proposed policies for creating an “essential health benefits” package, as required by the Patient Protection and Affordable Care Act (PPACA). These policies require health plans to cover items and services in at least ten categories of care. The categories include, but are not limited to:
In the December bulletin, HHS proposed that each state establish its own benchmarks for essential health benefits based on seven options, all referring to plans already in existence within a state. In Louisiana, five of the seven plans being considered as a benchmark are existing Blue Cross and Blue Shield of Louisiana products. We will continue to work closely with the state to ensure the final essential health benefits package is as comprehensive and affordable as possible.
Network News – Addition and Termination
We are pleased to announce the following addition to our facility networks:
Acute Care Hospital
Shriners Hospitals for Children
We regret having to notify you of the following Emergency Room physician group termination:
Van Meter Emergency Physicians
Please note: Because the group still participates in one of our networks, members are not directly impacted.