Health Plans for 2014: Why They're Different

Many of my small group and individual and family clients will be choosing a health plan for the next year that's new. Many of them may wonder why they can't just have the same health plan they're already enjoying. As you know, the Affordable Care Act (ACA) has meant many changes. It's a good idea to review some of the most significant ones that are driving changes in health plans.

• All small group and individual health plans must include the 10 essential health benefits. Many plans in the past included some, but not all, of these benefits.
• Four levels of coverage may be offered. These are often referred to as "metal levels" or "metal tiers" and they specify how costs are shared between health plan enrollee and health plan provider. In Washington state, there will be three levels of coverage offered in the market: Bronze, Silver, and Gold.
• Catastrophic health plans are no longer available to most people. They can only be purchased through the Washington Healthplanfinder—our state's online exchange marketplace—by someone younger than age 30 or someone who qualifies for a financial hardship.
• Health insurance cannot be denied for pre-existing conditions. This rule has been in place already for children, and takes effect for adults in 2014.

If you have or are on a small group medical plan (Employer sponsored plan) there will be some changes on January 1, 2014 but your plan won't "renew" and go through all of the changes until the contract year ends. Thus, if your plan renews every June for example, your exiting plan continues until the regular contract renewal date in June 2014. The only thing that can alter that date is to search for a new plan earlier than the contract renewal date, enroll to the new plan and terminate the old one.