One of the most significant changes effective with the Affordable Care Act implementation will be plan design changes. Individuals who have low deductible plans and others with very high deductible plans will not be able to retain the plan designs which they had previously enjoyed. The Affordable Care Act legislation does not allow for plans that are too rich or ones that are too lean, they have to be JUST right. As a result many insurance carriers are offering their insureds an option to renew their insurance contracts December 1 to postpone required changes until December of 2014.
Should you or your group accept early renewal? You would be wise to look very carefully at as many facets of this decision as you can. Rates have driven decisions in the past especially as pricing on health insurance has increased so dramatically. Plan design has been another serious consideration and should be even more so as we go into 2014. Take a moment to determine how you, your family and your employees normally use your health plans. Is most of your use in office visits and prescriptions? Then look carefully at copay costs and limits. Are you a heavy user of lab work, imaging or other outpatient services? Be careful about plans that have large copays for these services. Are you prepared for emergency room visits as they come up? Many plans no longer have copays, but apply these charges to the plan’s deductible and co-insurance. Behavior modification in this area is critical, but many of us will be dolphins caught in tuna nets, so read and choose carefully.
Network options are another area of change. Please do not think that the provider who currently participates in a carrier network will continue to participate in all the networks offered by the carrier. Be equally careful as you research prescription formularies. Drug lists look like they are going to slim down the brand name drugs they will approve. Will the drugs you are taking be the ones the plan you are considering has decided to include?
All of these considerations, and many more we do not have the time to discuss, should encourage you to move slowly into the new Affordable Care Act compliant plans. Renewing your plan December 1 will allow you the time to shop carefully as we move into the new year. If you determine that the 2014 plans will serve you and your family better you will be able to make changes before your December 1, 2014 renewal. If you decide that your 2013 plan suites you better you will have almost all of 2014 to find the 2014 plan that most closely matches what you would like.