The Patient Protection and Affordable Care Act (commonly referred to as Health Care Reform) will result in changes of which you need to be aware as we enter 2011. In accordance with newly required notification procedures, University Human Resources would like to provide to all employees with a summary of changes and other relevant information.
Cedarville University has determined that our Anthem Blue Access PPO plan is defined as a “grandfathered plan” under the Patient Protection and Affordable Care Act. As permitted by the act, a grandfathered health plan can preserve certain basic health coverage that was already in effect when the law was enacted. Being a grandfathered plan means that your Anthem Blue Access PPO plan may not include certain consumer protections of the act that apply to other non-grandfathered plans, but must comply with all required consumer protections as outlined within the act. Questions regarding which protections apply and which protections do not apply and what may cause a change in status from grandfathered to non-grandfathered may be directed to the Employee Benefits Security Administration, Department of Labor, at 1-866-444-3272 or by visiting www.dol.gov/ebsa/healthreform. This website has a table which summarizes the relevant information.
Adult children up to age 26 of all eligible employees now have access to our health plan. Employees with children whose coverage previously ended – or who were not eligible for coverage – because of age are eligible to enroll in Anthem Blue Access PPO through Cedarville University. Eligible employees covered by the health plan my request enrollment for such children effective as early as January 1, 2011. For more information or to enroll eligible child, please contact Cindy Fisher, Benefits Coordinator, by email at fisherc@cedarville.edu to request enrollment forms.
The lifetime limit on the dollar value of Benefits under the Anthem Blue Access PPO through Cedarville University no longer applies. Individuals currently enrolled will have no lifetime limitation imposed on most services including, but not limited to, ambulatory, emergency, preventive, mental health, substance abuse, rehabilitative, laboratory, pediatric, hospitalization, maternity, prescription drug and disease management services. For any plan participant whose coverage ended by reason of reaching a lifetime maximum limit under the plan are eligible to re-enroll in the plan. Such employee will have until December 31, 2010 to request re-enrollment.
If you are eligible for health coverage from your employer, but are unable to afford the premiums, assistance may be available to you to assist with paying the premiums. You may contact the Child Health Insurance program (CHIP) office by calling 1-877-KIDSNOW or visit www.insurekidsnow.gov to find out eligibility information and how to apply. Once it is determined that you or your dependents are eligible for premium assistance, you are permitted to enroll for a 60-day special enrollment period following the determination of your eligibility. For more information or to enroll during this special enrollment period, please contact Cindy Fisher, Benefits Coordinator, at extension 4126.