Experts at Fringe Benefit Group say right now is the "calm before the storm." As early as this fall, major changes to the limited medical industry will occur under the passage of the Patient Protection and Affordable Care Act ("PPACA") and the Health Care and Education Reconciliation Act of 2010.
"Coinsurance-based, expense incurred limited medical plans will be subject to new rules," says John Conkling, vice president of national accounts for Fringe Benefit Group. "Coinsurance-based, expense incurred limited medical plans will be subject to new rules.
"Brokers who currently market limited medical plans – or have customers utilizing limited medical plans – should contact their carrier partner immediately to find out their product strategy as a result of health care reform. They should ask 'How will health care reform affect renewals? Are you still accepting new business?' If the carrier can't give you straight answers, find a new limited medical partner who can."
Recommended For You
Beginning Sept. 24, according to Fringe Benefit Group, employers utilizing limited medical plans (also known as limited benefit plans or mini-meds) are facing many changes. This is also the time when grandfathered health insurance plans begin to renew.
Group health plans, even those which have been grandfathered, will have to meet new requirements, including no lifetime and annual limits, on or after Sept. 23, 2010. All limited medical plans that were considered "group health insurance plans;" plans that issued Letters of Creditable Coverage under HIPAA; plans identified as Limited Major Medical Plans that function similarly to traditional group plans with co-pays, deductibles, co-insurance and an annual overall maximum or a separate inpatient/outpatient maximum; will be subject to these new regulations effective Sept. 23.
- Employer groups renewing after September 23, 2010 that are currently on a limited medical plan subject to the health care reform rules regarding the removal of annual and lifetime limits have several options: Their carrier will not renew the plan because it cannot meet the new rules;
- They are renewed with significant rate increases; or
- They move to a fixed indemnity style limited medical plan.
"We're moving forward with our fixed indemnity limited medical product and we will continue to invest in technology and customer service to assist our customers. We understand things are going to change in our industry, but we have a go-forward plan in place to help our current and prospective customers right now," says Brian Robertson, executive vice president of Fringe Benefit Group. "We are only five months away from October renewals and most customers want and need to know about the future of their plans. We can provide them with answers – a solution – today."
Information about Fringe Benefit Group's Framework Health Plan and the latest news on the health care reform and its impact on the limited medical plan industry is available on the company's Web site www.frameworkhealthplan.com.
© 2025 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.
