Mental Health Parity Legislative Update
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In February 2010, guidance was released clarifying the impact of the Mental Health Parity Act of 2008 on benefit plans. This legislation affects all sponsors of group benefit plans with over 50 employees, whether they are fully insured or self-funded, and regardless of whether they are subject to ERISA. Coventry Health Care is working diligently to determine the employer's size to ensure that no employer that should be subject to the Mental Health Parity Act of 2008 is sold a benefit plan that is not in compliance with the act. Should Coventry Health Care sell a non-compliant benefit plan, we will be subject to substantial fines and penalties.
Ask yourself the following three questions when determining whether your client needs to comply with the Mental Health Parity Act:
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Did the group have an average of at least 50 employees during the preceding calendar year?
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Is this group part of a group of corporations or entities under common control that files a consolidated tax return?
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If so, did the groups that are part of the consolidated tax return employ an average of more than 50 employees during the preceding calendar year?
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| Uninterrupted Coverage for Young Adults Under the Age of 26 |
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Under the new health reform law, also known as the Patient Protection and Affordable Care Act (PPACA), health insurers and group health plans will experience major changes in how they operate. One change is a requirement to allow dependents up to age 26 to remain on their parents' health plans. This requirement takes effect for plan years that start on or after September 23, 2010, and applies to both new plans and so-called "grandfathered" plans.
On April 23, 2010, and well in advance of the new health reform requirements, Coventry decided that our Company and our affiliated health plans will provide uninterrupted coverage for all young adult dependents under age 26. This decision takes affect immediately and applies to young adult dependents currently covered under their parents' policies for our fully insured groups and CoventryOne policies.
At Coventry, we know the importance of maintaining continuous affordable health coverage for young adults and people of all ages. Moving up the timetable makes good business sense and provides assurance to parents that their children will continue to receive high-quality care at an affordable cost.
Click here to learn more about what this means to our members and employer-clients. |
HRA Product Design Update
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When determining pricing for any plan design, underwriters evaluate specific features of the plan, including deductibles, and assign a utilization credit based on the assumed impact of the deductible on utilization patterns. As employers have begun providing Health Reimbursement Arrangements (HRAs) toward some portion of the deductible, the funding has mitigated the effect of the deductible on utilization patterns resulting in higher health care usage than assumed in pricing. In response to this, underwriting guidelines have been revised to raise the previous minimum of $500 in deductible responsibility required from members to the greater of $500 or 50% of the deductible value.
Coventry Consumer Choice ("C3") has reissued the HRA Product Selection Sheet to eliminate standard designs not conforming to the aforementioned specifications. If C3 is not selected as the HRA administrator, Coventry expects our broker partners to understand the implications of an HRA design outside these guidelines. Our underwriters will need to evaluate the proposed plan design and determine whether rates that have been proposed by Coventry are appropriate with the additional level of funding by the employer. We appreciate your support in this matter. |
Safe Senders
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If you are not receiving emails notifying you that a new commission statement is available, please check to make sure that the following address is in your "safe senders" list. You may also use this address to send questions about your commissions.
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| Never Lose An Issue! |
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Remember seeing something in a past newsletter, but didn't keep the email? Not a problem anymore!
Past issues of the Broker News Flash beginning with January 2008 are now archived for easy access. Click on the link below and be directed to our past issues.
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| Coventry Health Care is a registered trade name of Carelink Health Plans. Inc. (Carelink), a West Virginia HMO. PPO products are underwritten by Coventry Health and Life Insurance Company and administered by Carelink Health Plans, Inc. in West Virginia. Benefits described herein are only a summary of the benefits available. A complete list of benefits, exclusions and the procedural requirements of the plan can be found in the Evidence of Coverage (CL.HMO.EOC.07) or Certificate of Insurance (CL.PPO.COI.07) and Schedule of Benefits (CL.SB.HMO.1-07 or CL.SB.PPO.1-07). |
