Fast Fact: ALL ACA-Compliant Health Insurance Plans MUST Contain Mental Health Benefits

Here’s a fast-fact for you on 2018 Mental Health Awareness Day: ALL ACA-compliant health insurance plans MUST contain mental health benefits. That’s a fact. 

Healthcare reform (a.k.a. Obamacare, a.k.a. the Affordable Care Act) required that “qualified health insurance plans” MUST contain “essential health benefits.” One of these essential health benefits is: access to mental healthcare.

Here’s what you should know about which health plans MUST contain mental health benefits:

  • Individual & Family Plans: if you purchase an ACA individual/family plan from the health insurance marketplace, or directly from an insurance company, these plans MUST contain mental health benefits.
  • Small Employer Health Plans: nearly all small employer plans usually contain mental health benefits. The size of a small employer is defined state-by-state. Many states recognize a small employer as a company with less that 50 full time equivalent employees. Some states recognize a small employer as a company with less than 100 full time equivalent employees.
  • Large Employer Health Plans: large employer health plans (usually employers with over 100 employees) are not required to contain mental health benefits, however MOST do. Make sure to do some research into your plan, to see what kind of mental health benefits are included.
  • Self Funded Health Plans: self funded health plans are NOT required to contain mental health benefits, but again, MOST of them do. Self funded plans are most typically provided by large (to very large) employers (examples: state employees, hospitals, very large corporations, etc). If you have a self funded plan, make sure to check whether-or-not you have access to mental health benefits.

In conclusion, mental health benefits can be IMPORTANT. There is a reason that they are contained in MOST health insurance plans. On Mental Health Awareness Day, we want to raise awareness that you most likely have access to these kinds of important “essential benefits.” For questions regarding individual and employer health insurance in the state of California, contact us anytime. 

Thanks for stopping by, we hope you found our information to be helpful. Check back at our blog to get further information about funding healthcare. Also, please share with your friends, clients, colleagues, and family. Here are a few of our other information outlets:

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California Officially Bans Short Term Health Insurance Plans

Here’s the down-low on “short term” health insurance plans in California. Short term health insurance plans were used as an alternative to “Obamacare” (ACA) plans if someone needed coverage for a short period of time (previously less than 3 months, and more recently, less than 12 months).

People who missed the individual and family plan open enrollment could enroll in these plans at anytime throughout the year. Additionally, people who were trying to “bridge a gap” in coverage (example: going from an employer plan to an individual plan, or an employer plan to a NEW employer plan), could utilize these short term plans to cover themselves during that period of time.

Short term health insurance plans are able to exclude certain benefits that “Obamacare” plans are required to contain (these requirements are called “essential health benefits”). For example, a short term health insurance plan can exclude things like maternity, mental health benefits, and can also utilize pre-existing condition exclusions when underwriting the plan. For these reasons, short term health insurance plans have a tendency to be much less expensive than “Obamacare” plans.

Recently, the Trump Administration officially released HHS/DOL guidance that expanded access to these plans nationwide, allowing people to participate in them for up to three years (instead of under 12 months). Also, the federal tax reform bill passed in December of 2017 removed the requirement for individuals to have health insurance, or pay a tax penalty. For these two reasons, there was anticipated to be MUCH more participation in short term health insurance plans, nationwide. 

However in 2018, California legislators recently passed S.B. 910, a bill that banned short term health insurance plans in the state ENTIRELY, starting on January 1st, 2019. The argument is that these short term plans are “junk plans” because they do not include the comprehensive “essential health benefits” that “Obamacare” plans ARE required to contain, as described previously in the blog post. Additionally, it’s the consensus that legislators would like to maintain participation in the state’s “Obamacare” (ACA) marketplace, in order to keep rates/premiums more stable.

Residents of California will have three choices in the individual marketplace in 2019:

  • Participate in an Obamacare/ACA plan individually, or at Covered California.
  • Find an alternative option to health insurance, like a health ministry plan, or an association health plan (if eligible).
  • Go uninsured (because there is no tax penalty anymore).

For further assistance finding affordable options in the state of California, be sure to contact us. We’ll put a comprehensive consultation together for you, so you’re able to see what health plan options are available in your zip code. Our recommendation is always to not go uninsured, when it comes to your health.

Thanks for stopping by, we hope you found our information to be helpful. Check back at our blog to get further information about funding healthcare. Also, please share with your friends, clients, colleagues, and family. Here are a few of our other information outlets:

Home Page: https://policyadvantage.com

Twitter: http://www.twitter.com/PolicyAdvantage

Facebook: http://www.facebook.com/PolicyAdvantage

YouTube: http://www.youtube.com/PolicyAdvantage

Pinterest: http://www.pinterest.com/PolicyAdvantage

Word Press: http://www.policyadvantage.wordpress.com