Here is an update concerning regulation relevant to the provisions of the Healthcare Reform Legislation passed this spring for dependant coverage to age 26.  The Department of Treasury, Labor and Health and Human Services have jointly posted interim rules for group health plans and health insurers relating to this issue.  IRS has posted Notice 2010-38 which allows plans to cover dependants who have not turned 27 through the end of the taxable year the dependant turns age 26.

Currently the plan administrators and trustees are aware of these changes, but they will not impact our plan until the next plan year start, April 2011.

So what are in the “new regulations” that will impact you health plan next year?

• Dependant coverage will no longer be conditioned on whether a child is a tax dependant, a student, resides with, or receives financial support from the parent.

• The definition of a child will now become “an individual who is the son, daughter, stepson, stepdaughter of the employee and a child includes both legally adopted individual of the employee and an individual who is lawfully placed with the employee for legal adoption by the employee.

• Examples of previously allowable eligibility restrictions on dependant coverage now cannot be used for defining eligibility or continued eligibility include:

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  • Financial dependency on the participant or any other person
  • Residency with the participant or any other person
  • Student status
  • Employment
  • Eligibility for other coverage
  • Martial status or
  • Any combination of these

Your plan will also be required to provide notice of a 30 day right to enrollment to dependants under age 26 not later than the first plan year beginning on or after September 23, 2010. Proper documentation for this will be provided upon request prior to next plan year start date.

Please refer any eligibility questions to RJ Lee and Associates at (309) 764-8080.

Health Insurance changes :

Benefit Period Deductible -  Single $1,500.00 / Family $3,000.00

Coinsurance – In-Network %20 / Out of Network %30

Office Services (Co-pay) – In-Network $30.00 / Out of Network %30 after deductible

Emergency Care – $150.00

Out of Pocket Maximum – Single $3,000.00 / Family $6,000.00

Life time Maximum – $2 millions

As of June 1, 2010 Dependants to the age of 26 will be able to stay covered by your benefit plan. You must ensure that they are currently listed as a dependant and eligible under the new Health Care Law rules.  Please contact our benefit coordinator at RJ Lee and Associates for further information.

You should have received your new benefit card, if your benefit card does not have a $30.00 co-pay listed on the front please contact Wellmark Blue Cross Blue Shield customer service to have new card sent to you.

The Health and Welfare Trustees met on April 26^th to discuss further health insurance benefit options for the next benefit period. We are currently looking into possible changes to the plan that will be needed to be made per the new Affordable Health Care Act passed by Congress early this year.  We will be passing on any changes that will affect the members and their families as they come to pass.

Remember to inform RJ Lee of any changes to dependents as soon as they happen, this will ensure coverage to those whom are eligible.