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Navigating Federal Healthcare Reform— A Summer Series from Insurance Consumer Advocate Sean Shaw

Sean M. Shaw, Florida Insurance Consumer AdvocateDepartment of Financial Services, Consumer eViews Volume 7 Number 24

June 11, 2010

The enactment of the Patient Protection and Affordable Care Act Office of the Insurance Consumer Advocateon March 23, 2010 has left many consumers with numerous questions about how the new legislation will affect them. In an effort to provide consumers with vital information regarding the new legislation, the Office of the Insurance Consumer Advocate will publish a summer series explaining how consumers will be impacted by the health care reform bill. Many of the changes will take several years to implement thus; prepared consumers will have an advantage when making health insurance decisions.

In the first installment of the Patient Protection and Affordable Care Act series, consumers will be provided with an overview of the benefits that took immediate effect as a result of the President signing the Patient Protection and Affordable Care Act into law.

The following are the immediate changes that have taken effect:

  • Eligible beneficiaries with Part D coverage who fall into the “doughnut hole”, a gap in Medicare Part D prescription drug coverage, in 2010 can receive a one-time $250 rebate to pay for prescription drugs that were purchased while in the “doughnut hole”. The “doughnut hole” will be phased out in future years.
  • Businesses with 25 or fewer full-time employees that pay for at least 50 percent of premiums, and pay average annual wages below $50,000, may be eligible for a tax credit of up to 35 percent of the premiums the business pays.
  • Grant money will be provided to states to establish consumer assistance programs which will provide consumers with an external review by an independent third party when disputes arise.
  • Health insurance companies can no longer rescind policies except in cases of fraud.

Consumers that have any further questions regarding the immediate changes that have taken effect since the passage of the Patient Protection and Affordable Care Act, should contact the Division of Consumer Services within the Department of Financial Services on-line at http://www.myfloridacfo.com/Consumers/ or by phone at 1-877-MY-FL-CFO (1-877-693-5236), toll-free in Florida, and (850) 413-3089 from out of state.

The Insurance Consumer Advocate is appointed by Florida CFO Alex Sink and is committed to finding solutions to insurance issues facing Floridians, calling attention to questionable insurance practices, promoting a viable insurance market responsive to the needs of Florida’s diverse population and assuring that rates are fair and justified.