The next round of provisions in the Patient Protection and Affordable Care Act goes into effect Thursday, Sept. 23. New or expanded options as well as consumer protections for health insurance coverage are included in many of these provisions and could represent major changes to policy options during open enrollment or when renewing an individual health policy, according to the National Association of Insurance Commissioners, Kansas City, Mo.

For those with employer-covered health insurance coverage, the new benefits and protections will be added to their policies on the subsequent renewal date after Sept. 23, the NAIC says. An individual health insurance policy, however, has differing dates. The new provisions for insurers that specified a "policy year" for coverage will become effective on said date. Otherwise, when annual deductibles and annual limits reset each year, the new benefits and protections will be appended. For policies with no annual deductible or limit, these changes will become effective on Jan. 1, 2011.

Grandfathered plans are exempt from most changes required by the PPACA, the NAIC states. However, if the plan's benefits are significantly reduced or deductibles, copayments or an employee's share of premium contributions are raised, the grandfathered status and its exemptions will be lost.