An Introduction to the Affordable Care Act

The patient protection and Affordable Care Act not only aims to increase access to health care for all but will protect consumers rights. The act will call for insurance companies to be held accountable for the quality of plans that they offer consumers and make it easier for consumers to understand their coverage. Programs set up under the Affordable Care Act, such as benefit exchanges, also serve as an intermediary between consumers and insurance companies, particularly to help manage any problems that may occur, such as carriers refusing to pay for certain treatments. In this case, exchanges may analyze the consumers’ case and offer advice regarding their rights.

In terms of the cost of health insurance, insurance companies may not be able to increase premiums without good cause. Moreover, cost of health insurance will also be based on the total household income of the consumer. For example, if receiving health insurance through an employer, the cost of premiums must be a certain percentage of the total household income. To mitigate the increased costs of health insurance, employers may be able to utilize public and private benefit exchanges or receive tax credits to help them to afford continuing to provide   group coverage. Alternatively, if employees are unable to afford group coverage, they may be eligible for a free choice voucher. Under this voucher system, the employer will offer to pay the costs that they would have contributed had the employee been participating in the group coverage, but it would allow employees to purchase cheaper health insurance elsewhere. Consumers will also be assisted in choosing health insurance through consumer assistance programs.

Other changes taking place as part of the Affordable Care Act include changes to the plans offered. For example, plans will be required to cover pre-existing condition, to provide summaries of benefits and coverage, making it easy for consumers and employers to choose plans. Overall, the Affordable Care Act aims to improve the quality and affordability of health care, ensuring that preventative services are available to prevent chronic disease and improve overall public health.

Many companies are choosing to outsource their HR tasks, particularly larger companies. This provides many benefits, including working with consultants who specialize in HR and benefits and who have a thorough understanding of the health care reform, laws, regulations and employers new responsibilities. They are also able to provide suggestions in choosing the best benefit plans, including ways to streamline the administrative process in ways which are cost effective. These solutions enable companies to continue to control the process but relinquish certain tasks to consultant companies, including implementing integrated software solutions which help to support the process.

Companies may be required to engage in greater strategic planning to determine their ability to continue to afford coverage and to analyze current employee data, to determine employee preferences and needs with regards to health care coverage. Finding ways to effectively manage the enrolment process, the benefit administration and apply analytics to the data collected during this process, are all important considerations, and help to support the concept of consumer driven health.

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