1. What You Need To Know About Health Care Reform
<Insert Date.>
<Insert Your Company Name or Logo.>

2. Health Care Reform Key Facts
March 23, President Obama signed the Affordable Care Act.
A central goal of the ACA is to significantly reduce the number of uninsured by providing affordable coverage options through Medicaid and new Health Insurance Marketplaces. The law requires most people to maintain a minimum level of health insurance coverage beginning in 2014.
Oct. 1, 2013 – Health Insurance Marketplaces open.
Jan. 1, 2014 – Coverage begins.

3. What is a Health Insurance Marketplace?
An online marketplace where individuals may:
Shop for health insurance.
Compare benefits and prices.
Enroll in a plan.
There will be two types of Health Insurance Marketplaces in the US:
Public–facilitated by state and/or federal government. (Tax Credits and Subsidies available for qualified individuals.)
Private–facilitated by private companies.
State marketplaces will be accessible at:
The law requires each state to establish a health insurance exchange that provides a marketplace for individuals and small employers to buy major medical insurance by January 1, 2014.

4. Who can use a Health Insurance Marketplace?
Individuals and families who don’t have access to affordable employer-provided health care.
Health care is not considered affordable if employee’s portion of individual premium exceeds 9.5% of their household income.
Small Employers can access Small Business Health Options Program (SHOP) exchanges to provide employer-sponsored coverage.

5. Public Marketplaces will offer 4 coverage levels
Bronze: plan pays 60% of “essential health benefits”
Silver: plan pays 70% of “essential health benefits”
Benchmark
Gold: plan pays 80% of “essential health benefits”
Premium: plan pays 90% of “essential health benefits”
Low income consumers may be eligible for subsidies to assist with premium expenses and out-of-pocket expenses.

6. Plans must include “Essential Health Benefits”
Ambulatory patient services
Emergency services
Hospitalization
Maternity and newborn care
Mental health and substance abuse disorder services, including behavioral health treatment
Prescription drugs
Rehabilitative and habilitative services and devices
Laboratory services
Preventive and wellness services and chronic disease management
Pediatric services, including oral and vision care

7. Plans must provide “Preventive Care” at no cost
You will not have to pay a copayment, co-insurance, or deductible to receive certain preventive health care:
Blood pressure, diabetes, and cholesterol tests
Many cancer screenings, including mammograms and colonoscopies
Counseling on such topics as quitting smoking, losing weight, eating healthfully, treating depression and reducing alcohol use
Regular well-baby and well-child visits, from birth to age 21
Routine vaccinations against diseases such as measles, polio or meningitis
Counseling, screenings and vaccines to ensure healthy pregnancies
Women’s wellness and pre-natal visits
Flu and pneumonia shots

8. Additional changes to health care plans …
Guaranteed Issue and Renewal
Plans cannot deny coverage based on “pre-existing” conditions.
Plans cannot exclude “pre-existing” conditions.
Plans cannot charge a higher premium for “pre-existing” conditions.

9. For us at <insert company name>, this means…
Slide Option 1: Employer Offering Major Medical Benefits
Our company will offer the following major medical benefits:
<Insert benefit and vendor details>
Open Enrollment begins: <Insert date>
Costs: <Insert cost details>
Our company will offer the following voluntary benefits:

10. For us at <insert company name>, this means…
Slide Option 2: Employer NOT Offering Major Medical Benefits
While our company will not offer major medical benefits, you will have access to the Health Insurance Marketplace.
Open Enrollment begins: October 1, 2013
Visit: <Insert State Exchange website address>
Our company will offer the following voluntary benefits:
<Insert benefit and vendor details>
Open Enrollment begins: <Insert date>
Costs: <Insert cost details>

11. For more information…
Healthcare.gov
Kaiser on Health Care Reform
U.S. Small Business Administration/Health Care
Aflac Healthcare Reform Resources

12. Questions