Welcome! Login | Register
 

The Scoop: Chamber Makes Bond Endorsements, Yes on 7 Campaign Launch, and More—Welcome back to The Scoop, the 4 p.m.…

Rhode Island Residents Celebrated for 25 Years of Participation in CVS Health Downtown 5k—A group of Rhode Islanders called "The Dashers"…

Friday Financial Five -September 19, 2014—A positive report out of the New York…

What To Watch For: Patriots vs. Raiders—The Patriots will finally play their home opener…

5 Live Music Musts - September 19, 2014—The last weekend of summer brings a nice…

The Cellar: Two Wines You Should Always Have On Hand—Pick them up this weekend...

Blue Cross & Blue Shield of RI to Host Annual Day of Service—Blue Cross & Blue Shield of Rhode Island's…

RI Unemployment Remains at 7.7 % in August—The RI Department of Labor and Training announced…

The Scoop: Cianci’s New Plan, Fung Got New TV and More—Welcome back to The Scoop, the 4 p.m.…

Rhode Island’s Best Wineries—As a companion to last week's brewery piece,…

 
 

Smart Benefits: New Law Eliminates Limits on Deductibles

Monday, April 07, 2014

 

Another piece of the healthcare reform law – deductible limits for small group plans – has been repealed.

On April 1, 2014, the Protecting Access to Medicare Act of 2014 (the Act) was enacted. Section 213 of the Act contains a provision that eliminates the limitation on deductibles for employer-sponsored health plans, which was part of the Affordable Care Act (ACA).

Limits Drove Costs

Earlier this year, non-grandfathered, small employers were forced to change their plan design deductibles effective for January 1 coverage if their deductibles were $2,000 (self-only) or $4,000 (other than self-only), or higher. As a result, many employers had to terminate plans previously in effect and adopt new ones – often with higher premium costs for employers and employees, who previously had higher deductibles in exchange for lower premiums.

The limit on deductibles was also problematic for those small employers who offered higher deductible plans in tandem with health reimbursement arrangements (HRAs) to legally reimburse partial deductible expenses for employees.

Change Means More Flexibility

Now, because the deductible limits have been repealed, employers will once again have more flexibility with the plan designs they offer. That means they can eliminate deductibles, or set deductible limits at any level below the plan’s out-of-pocket maximum (OOPM), as long as they are allowed under state laws and regulations.

Other Limits Remain

However, some limits on plans sold after January 1, 2014, will remain:

· The annual limits on a plan’s out-of-pocket maximum ($6,350 for self-only coverage and $12,700 for other than self-only coverage) are still in effect

· The requirement that all in-network cost sharing (including deductibles and flat dollar copayments) must accumulate to the plan’s OOPM remains in effect.

Amy Gallagher has over 21 years of healthcare industry experience guiding employers and employees. As Vice President at Cornerstone Group, she advises large employers on all aspects of healthcare reform, benefit solutions, cost-containment strategies and results-driven wellness programs. Amy speaks regularly on a variety of healthcare-related topics, and is often quoted by national publications on the subject matter. Locally, Amy is a member of SHRM-RI, the Rhode Island Business Group on Health, and the Rhode Island Business Healthcare Advisory Council.

 

Related Slideshow: Preventable Deaths in American Hospitals

Prev Next

To Err is Human

In 1999 the Institute of Medicine published the bombshell “To Err Is Human” report, which revealed that up to 98,000 people a year die because of mistakes in hospitals. Though initially disputed, the report is now widely accepted by doctors and hospital officials, including RI Dept. of Health Director Dr. Michael Fine.

Prev Next

Health and Human Services

In 2010, the Office of Inspector General for Health and Human Services said that bad hospital care contributed to the deaths of 180,000 patients in Medicare alone in a given year.

Prev Next

Journal of Patient Safety

In 2013, the Journal of Patient Safety published research that claims the number of preventable deaths may be much higher — between 210,000 and 440,000 patients each year who go to the hospital for care suffer some type of preventable harm that contributes to their death. That's roughly one-sixth of all deaths in the United States each year. 

Prev Next

John. T. James, Ph.D

Based on that 2013 Journal of Patient Safety report by John T. James, Ph.D, medical errors are the third-leading cause of death in America, behind heart disease, which is the first, and cancer, which is second. 

Prev Next

Over Treatment

Many preventable deaths are the result of "over treatment," according to Dr. Michael Fine, Director of the Rhode Island Department of Health, who said 30 to 50 percent of all medical procedures are unnecessary.

Prev Next

Unnecessary Admissions

According to Dr. Michael Fine, Director of the Rhode Island Department of Health, at least 11 percent of ALL hospital admissions are unnecessary.

Prev Next

Healthcare Improvement

The Institute for Healthcare Improvement estimates there are 15 million incidents of medical harm each year.

Prev Next

Checklist Protocol

Dr. Peter Pronovost, Johns Hopkins Medicine’s senior vice president for patient safety and quality, has developed a scientifically proven method for reducing the deadly infections associated with central line catheters. His simple but effective checklist protocol virtually eliminated these infections across the state of Michigan, saving 1,500 lives and $100 million annually.

 
 

Related Articles

 

Enjoy this post? Share it with others.