2016 was a wild one, huh? It seems like just about everyone is ready to put it in the rear view mirror and see what 2017 has in store. On the health insurance side of things, there are a few changes you’ll want to watch —
Some Premium increases — Yes, some plans are seeing increases for 2017 and/or rises in co-pays or coinsurance percentages that employees have to pay. But many plans are where they were last year and we’ve even seen some decreases out there.
President Trump and the Republican Congress — The biggest of all is the campaign promise to “repeal and replace Obamacare” with something great. And as we outlined earlier this year, the new Trump plan will probably include increased out of state competition to regulate pricing. As we always say, a campaign promise is not the law so we follow what is law until a new law is passed.
Non-discrimination for Transgender Reassignment Surgery – The current exclusion will be deleted and this will become a standardly covered service. Cosmetic services will continue to be excluded and will not change due to ACA 1557. Travel and lodging will also not be included as covered services.
Comprehensive and Advanced Reproductive Technology (ART) Infertility Services – For plans offering Comprehensive and ART benefits, currently, members that have undergone transgender reassignment surgery are not eligible for infertility services. As a result of ACA 1557 this exclusion will be removed and coverage decisions will be evaluated on a case by case basis, taking other underlying medical issues into consideration. This also applies to transgender members who have not gone through reassignment surgery.
Applied Behavioral Analysis (ABA) – ABA is currently mandated coverage in many states. Under the OCR Rule, ABA services must be covered if given a diagnosis of Autism Spectrum Disorder. This change expands ABA coverage on plans to all states.
Always a good idea at your renewal time or the beginning of a new year to review your plan and make sure you understand all of the changes affecting your business. My team of employee benefits and health insurance superheroes are standing by to answer any of your questions and guide you through this stuff.
Until then, we’ll see you next year!