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The Affordable Care Act - What's it All About?

What is the ACA? 

The ACA is a federal law, signed by President Obama on March 23, 2010, intended to significantly reduce the number of uninsured in the United States.

The Act contains more than 2,500 pages of legislation and mandates fundamental changes to the health insurance industry through a wide variety of new rules and regulations.

How will the ACA affect my health plan?

That depends on the status of your health plan as "grandfathered" or "non-grandfathered" under the law.

  • Non-grandfathered plans are required to comply with all the ACA mandates,
  • Grandfathered plans are only required to comply with some of them.

Your plan is grandfathered if it existed on or before the date the law became effective, and it has not changed since that date. 

 

Your plan is non-grandfathered if it is either a new plan or an existing plan that changed significantly since the law was signed.

 

What are the new rules and when do they take effect?

There are a wide variety of rules and regulations that will become effective through 2014. For more information and a look at how they will affect you, check out the timeline  and the interactive tools and videos.

What is Wellmark doing in response to the ACA?

We are working hard to:

  • Meet the many requirements of the new law.
  • Implement reform in a way that benefits all Iowans and South Dakotans.
  • Keep service to our existing and new customers running smoothly, with minimal disruption.  

 

Wellmark is not providing any legal advice with regard to compliance with the requirements of the Affordable Care Act ("ACA") and Mental Health Parity and Addiction Equity Act ("MHPAEA"). Regulations and guidance on specific provisions of the ACA and MHPAEA have been and will continue to be provided by the U.S. Department of Health and Human Services ("HHS") and/or other agencies. The information provided reflects Wellmark's understanding of the most current information and is subject to change without further notice. Please note that plan benefits, rates, renewal rate adjustments, and rating impact calculations are subject to change and may be revised during a plan's rating period based on guidance and regulations issued by HHS or other agencies. Wellmark makes no representation as to the impact of plan changes on a plan's grandfathered status or interpretation or implementation of any other provisions of ACA or MHPAEA. Any questions about Wellmark's approach to the ACA or MHPAEA may be referred to your Wellmark account representative. Wellmark will not determine whether coverage is discriminatory or otherwise in violation of Internal Revenue Code Section 105(h). Wellmark also will not provide any testing for compliance with Internal Revenue Code Section 105(h). Wellmark will not be held liable for any penalties or other losses resulting from any employer offering coverage in violation of section 105(h). Wellmark will not determine whether any change in an Employer Administered Funding Arrangement affects a health plan's grandfathered health plan status under ACA or otherwise complies with ACA. Wellmark will not be held liable for any penalties or other losses resulting from any Employer Administered Funding Arrangement. For purposes of this paragraph, an "Employer Administered Funding Arrangement" is an arrangement administered by an employer in which the employer contributes toward the member's share of benefit costs (such as the member's deductible, coinsurance, or copayments) in the absence of which the member would be financially responsible. An Employer Administered Funding Arrangement does not include the employer's contribution to health insurance premiums or rates.


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