Landmark health care reform legislation has created sweeping changes for employers and their group health plans. For example, employers need to make key decisions, formally amend their group health plans and implement other measures to comply with this new legislation, including:

  • A decision to maintain or not maintain grandfathered status.
  • Removing preexisting conditions for children (and adults by 2014), lifetime and annual dollar limits for certain services, and waiting periods in excess of 90 days.
  • Extending coverage to adult children up to age 26.
  • For non-grandfathered plans, covering all recommended preventive services at no cost to participants; satisfying additional patient protection rights; and satisfying enhanced claim appeal and external review procedures.
  • Notifying participants of these rights and satisfying other new reporting and disclosure requirements.

For many of these provisions, employers need to take action before the end of its current plan year.