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The Supreme Court of the United States today upheld the health care reform Affordable Care Act (ACA), signed into law on March 23, 2010.
Impact of Decision: Things to consider
Rest assured, Wellmark Blue Cross and Blue Shield has already made great strides in implementing early provisions. We will continue to implement the various provisions required by the law while working with policymakers to address provisions that will increase costs, such as the health insurance tax that will add hundreds of dollars to families’ premiums each year. We plan to remain engaged in state-based health care exchange discussions, and will continue to provide input to policymakers as they develop the best approach to establishing a successful exchange model in Iowa and South Dakota.
Our Ongoing Commitment
As always, we will remain focused on making sound fiscal decisions that best serve our members.
As evidence, Wellmark is one of the few Iowa insurance companies to exceed the ACA medical-loss ratio requirement to spend 85 percent of premium dollars on medical claims in the large group market (100+ employees), and 80 percent in the individual and small group markets.
We will continue to provide timely information to you as it becomes available. In the meantime, additional information can be found on the Health Care Reform page of Wellmark.com.
Wellmark is not providing any legal advice with regard to compliance with the requirements of the Affordable Care Act ("ACA"). Regulations and guidance on specific provisions of the ACA 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. Any questions about Wellmark's approach to the ACA 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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