eHealth ObamaCare Countdown: Your First Step to Get Ready for Health Care Reform This Year

eHealth ObamaCare Countdown: Your First Step to Get Ready for Health Care 
Reform This Year 
MOUNTAIN VIEW, CA -- (Marketwired) -- 05/21/13 --  Today eHealth, Inc
(NASDAQ: EHTH), parent company of eHealthInsurance.com, the nation's
first and largest private online health insurance exchange, published
the first step in its six step guide to help consumers prepare for
health care reform and this year's new open enrollment period, which
begins Oct. 1, 2013.  
Beginning in 2014, individuals and families who do not have major
medical health insurance that meets minimum federal standards will be
subject to a tax penalty, which has been dubbed "the mandate tax."
The intricacies of the mandate tax will be explained in greater
detail in Step 2.  
Step 1: May, 2013: Find out if your current health insurance plan
will need to change in 2014 
When the Affordable Care Act (ACA) was signed into law, it
effectively created three classes of individually-purchased major
medical health insurance plans:  


 
--  Grandfathered plans: Insurance policies purchased and active before
    March 23, 2010, when the ACA was signed into law. These plans do not
    have to meet all the requirements of the law.
--  Non-grandfathered plans: Plans purchased after March 23, 2010, with
    coverage in effect before January 1, 2014. These purchases took place
    during the transition to a federally regulated individual health
    insurance market. All non-grandfathered plans meet some of the new
    benefit standards required by the ACA, and some plans include them
    all. Plans that don't meet all of the new benefit standards may need
    to be updated at some point in 2014.
--  New plans: Insurance purchased after January 1, 2014. These plans
    include all the mandatory benefits required by ACA.

  
Here's how the three types of plans differ: 


 
                                                                            
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         Mandated Plan Benefits         Grandfathered      Non-     New Plan
                                             Plan     Grandfathered         
                                                           Plan             
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Access to Lost Coverage Due to Exceeded    Required         NA         NA   
Limits: Those who lost coverage after                                       
exceeding a policy's lifetime limit may                                     
re-enroll in the same plan or one                                           
comparable.                                                                 
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Lifetime Coverage Limits: No lifetime      Required      Required   Required
dollar limits on essential benefits.                                        
----------------------------------------------------------------------------
Rescission Protection: Insurers cannot     Required      Required   Required
rescind coverage unless intentional                                         
fraud is committed.                                                         
----------------------------------------------------------------------------
Rescission Appeals: If insurers try to     Required      Required   Required
rescind coverage, customers have thirty                                     
days to appeal.                                                             
----------------------------------------------------------------------------
Children up to age 25: Adults under 26     Required      Required   Required
may rejoin a parent's plan under                                            
certain circumstances.                                                      
----------------------------------------------------------------------------
No Annual Coverage Limits: Annual        Not Required    Required   Required
dollar limits on coverage go away.                                          
----------------------------------------------------------------------------
No Cost-sharing for Preventive           Not Required    Required   Required
Services: Insurers are required to                                          
cover certain preventive medical                                            
services without cost-sharing.                                              
----------------------------------------------------------------------------
Community Rating: Plans are no longer    Not Required  Not Required Required
priced individually, based on a                                             
person's health.                                                            
----------------------------------------------------------------------------
Guaranteed Issue: An individual's        Not Required  Not Required Required
application for insurance can't be                                          
declined because of a pre-existing                                          
medical condition.                                                          
----------------------------------------------------------------------------
Essential Health Benefits: Each plan     Not Required  Not Required Required
must cover health benefits in ten                                           
categories deemed to be essential.                                          
----------------------------------------------------------------------------
Actuarial Values: Plans cover at least   Not Required  Not Required Required
60% of the total average annual costs                                       
an insurer expects to incur per                                             
customer.                                                                   
----------------------------------------------------------------------------

 
Non-Grandfathered Policyholders
 Although the timing is uncertain, the
new health care law requires non-grandfathered plans to be updated to
the new benefits standards. The table below outlines how, why and
when some people in non-grandfathered plans may need to update their
coverage: 


 
                                                                            
----------------------------------------------------------------------------
Why: Reasons a Plan   Does Not Cover All Essential Health Benefits: Starting
Change May Be         in 2014, people on a Non-Grandfathered plan that does 
Required              not cover all 10 essential health benefits may not be 
                      exempt from the individual mandate tax described      
                      above.                                                
                      ------------------------------------------------------
                      Does Not Meet Actuarial Value Requirements: Starting  
                      in 2014, all non-grandfathered plans must cover at    
                      least 60% of the total average annual costs an insurer
                      expects to incur per customer. If a plan doesn't cover
                      at least 60% of the actuarial value, it may need to be
                      updated for policyholders to avoid the individual     
                      mandate tax.                                          
----------------------------------------------------------------------------
How: Changes May Be   Passive Reenrollment - Some insurers may choose to    
Implemented in the    proactively move customers to new plans that meet     
Following Ways        Affordable Care Act requirements, without requiring a 
                      signature or active reenrollment into a new plan.     
                      ------------------------------------------------------
                      Active Reenrollment - Some insurers may require       
                      customers to actively opt into a new plan, which may  
                      even include acquiring new signatures.                
                      ------------------------------------------------------
                      Active Communication, Non-Enrollment - If possible,   
                      some insurers may allow customers keep their existing 
                      plan, but make them aware that this plan no longer    
                      keeps them exempt from the individual mandate tax.    
----------------------------------------------------------------------------
When: Timing of Plan  During the Initial Enrollment Period - Some insurers  
Changes May Vary      may use passive reenrollment or active reenrollment to
                      transition people from non-grandfathered plans to new 
                      plans between October 1, 2013 and March 31, 2014. This
                      six month initial open enrollment period has been put 
                      in place because 2014 is the first year that major    
                      provisions of the law go into effect.                 
                      ------------------------------------------------------
                      On A Plan's Renewal Date / Anniversary - Some insurers
                      may seek to conduct an active or passive reenrollment 
                      when that plan is up for renewal. Adoption of this    
                      approach may vary from insurer-to-insurer and from    
                      state-to-state, based in part upon that state's       
                      regulations.                                          
----------------------------------------------------------------------------

 
Additional Consumer Resources:  


 
--  Shop for health insurance plans from over 200 of America's leading
    insurers at eHealthInsurance.com
--  Shop for Medicare plans from some of America's leading Medicare
    providers at eHealthMedicare.com
--  Download or request a FREE printed copy of our book, Individual Health
    Insurance For Dummies, Health Care Reform Special Edition, produced in
    cooperation with For Dummies(R), a branded imprint of Wiley, and
    co-authored by eHealthInsurance
--  Follow eHealthInsurance's consumer blog, Get Smart - Get Covered
--  Browse our answers to real-life health insurance questions on Yahoo
    Answers
--  Follow eHealthInsurance on Facebook and Twitter

  
About eHealth
 eHealth, Inc. (NASDAQ: EHTH) is the parent company of
eHealthInsurance, America's first and largest private health
insurance exchange where individuals, families and small businesses
can compare health insurance products from leading insurers side by
side and purchase and enroll in coverage online. eHealthInsurance
offers thousands of individual, family and small business health
plans underwritten by more than 200 of the nation's leading health
insurance companies. eHealthInsurance is licensed to sell health
insurance in all 50 states and the District of Columbia. eHealth,
Inc. also provides powerful online and pharmacy-based tools to help
seniors navigate Medicare health insurance options, choose the right
plan and enroll in select plans online through its wholly-owned
subsidiary, PlanPrescriber.com (www.planprescriber.com) and through
its Medicare website eHealthMedicare.com (www.eHealthMedicare.com).  
For more health insurance news and information, visit the
eHealthInsurance consumer blog: Get Smart - Get Covered  
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For media inquiries, please contact:  
Sande Drew
eHealth, Inc.
(916) 207-7674
sande.drew@ehealth.com 
Kris Kraves
Cogenta Communications
(805) 527-7733 - direct
kris@cogentacom.com 
 
 
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