Health Care Reform:
What it Means for You

Federal Health Care Reform

NHP is committed to providing you with information about federal health care reform and how it affects your coverage.

Preventive Services Covered under the Affordable Care Act (PPACA)

PPACA is a federal law that went into effect on March 23, 2010. Among other provisions, the law puts into place comprehensive health insurance reforms that are intended to lower health care costs, guarantee more health care choices, and enhance the quality of health care for all Americans. PPACA will not be implemented all at once. Portions of the law have already taken effect. Other changes will be implemented through 2014 and beyond.

Current Benefit Changes*

We are currently in the process of implementing the following benefit changes to comply with PPACA:

Preventive Services

Under PPACA, certain preventive services must be covered without your having to pay any cost-sharing (deductible, copay or coinsurance) when these services are delivered by a network provider. Cost-sharing will be removed on covered preventive care services for plan years beginning on or after September 23, 2010. NHP began implementing this change on all new Business Choice and Commonwealth Choice policies as of October 1, 2010 and on all existing Business Choice and Commonwealth Choice policies as of January 1, 2011. Most custom plans will change upon renewal.

Covered preventive care services include:

• Those specified by the United States Preventive Services Task Force (USPSTF), the Advisory Committee On Immunization Practices (ACIP) and the Bright Futures recommendations for Pediatric Preventive Health Care.

  To view the complete list of Preventive Services, visit the HealthCare.gov website.

Child Dependent Coverage

Dependent children will no longer lose coverage upon loss of IRS dependency status; rather, all dependent children will be allowed to remain covered until they reach the age of 26.

• Effective October 1, 2010, this change applies to all standard NHP Business Choice and Commonwealth Choice HMO plans.

Durable Medical Equipment(DME)

PPACA includes eliminating any limits that apply to covered essential health care benefits. Fortunately, NHP's benefits do not include lifetime or significant annual limits on essential health benefits, with the exception of the annual limit for DME. NHP considers DME to be an essential health care benefit as defined by this new regulation and therefore is removing the $2,500 calendar year limit that currently applies. This change is effective January 1, 2011 on all standard NHP Business Choice and Commonwealth Choice HMO plans.

Check the Status of your DME benefits:

• Business Choice
  
• Commonwealth Choice
  

Additionally, to minimize premium increases after the DME coverage limits are removed, NHP is adding 20% coinsurance to the DME benefit. This change is effective April 1, 2011 on all standard NHP Business Choice and Commonwealth Choice HMO plans and to custom plans upon renewal.

Questions?

Call the NHP Customer Care Center at 1-800-462-5449 (TTY 1-800-655-1761). Our hours of operation are Monday through Friday from 8:00am to 6:00pm and Thursday from 8:00am to 8:00pm.

*These changes do not affect all NHP plans. Be sure to check with your employer for details on your specific plan.