Legislative Issues

State Legislation

Mickle By Sunee Mickle, Director of Government Relations,
& Lindsey Scott, Intern, Government Relations,
Blue Cross and Blue Shield of Kansas

May 28, 2010

Federal Health Care Reform

Blue Cross and Blue Shield of Kansas recently added a health care reform link to our website. This link provides our members with information regarding the new health care reform law, as well as answers frequently asked questions. You can view the federal health care reform website and request to receive our e-Newsletter by visiting www.bcbsks.com/news/SpecialReports/HealthCareReform/timeline.htm or by selecting the health care reform link located on the upper right hand side of the BCBSKS homepage.

Dependent Coverage Extended to Age 26

Beginning June 1, 2010, BCBSKS will raise the age limitation for some adult dependents in advance of the effective date of the new health care reform law. Specifically, BCBSKS will raise the age limitation to age 26 for adult dependents who were insured under a BCBSKS group or non-group plan on June 1, 2010.

This change will not apply to any adult dependents, who were not insured under dependent coverage by BCBSKS on June 1, including:

  • those insured under BCBSKS policies created after June 1,
  • insured transferring from another insurer after June 1, or
  • adult dependents who reached their age limitation prior to June 1.

For plans in place on March 23, 2010, this change will not apply to adult dependents who are eligible for other employer-based coverage. This change will apply to self-funded group plans only if the employer chooses to implement it.

The dependent coverage age change is required under the new health care reform law. Under the law, BCBSKS is not required to provide this coverage until Oct. 1, 2010, however we have established the change now in order to assist dependents in any "gap" of coverage and better serve our members.

Early Retiree Reinsurance Program

The Early Retiree Reinsurance Program, established under the Patient Protection and Affordable Care Act (PPACA), takes effect June 1, 2010; this is in advance of the June 21 start date required by the Affordable Care Act. The program provides $5 billion in aid to employers to help them continue to provide affordable coverage for early retirees, age 55 and older, who are not yet eligible for Medicare. The program expires on Jan. 1, 2014, or when $5 billion is exceeded.

Health benefits that qualify for relief include: medical, surgical, hospital, prescription drug and other benefits that may be specified by the Secretary of Health and Human Services. Eligible employers may apply for the program through the Department of Health and Human Services (HHS); these applications will be available on the HHS website, http://www.hhs.gov in early June. In order to become eligible for this program, an individual must:

  • Be a former employee of the employer who either established or contributed to the insurance plan.
  • Spouses, surviving spouses and dependents of eligible retirees are incorporated in the plan, even if they are not 55 years of age and are eligible for Medicare.

Plans eligible to apply are those self-funded or insured plans, including plans sponsored by private entities, state and local governments, nonprofits, religious entities, unions, and other employers. The plan must be maintained by one or more employers.

Eligible employment-based plans who have submitted a valid claim will be reimbursed 80 percent of the costs attributable to the claim as long as the claim exceeds $15,000 and is no greater than $90,000.

Helpful Links

Stay informed about the Federal Health Care Reform law and other health insurance issues by visiting the following websites:

Learn more about federal health insurance reform from Blue Cross and Blue Shield of Kansas at: www.bcbsks.com/news/SpecialReports/HealthCareReform/timeline.htm

Or the Kansas Insurance Department at: www.ksinsurance.org/consumers/healthreform/hcr.htm

For more information on the Early Retiree Reinsurance Program please visit: www.whitehouse.gov/the-press-office/fact-sheet-early-retiree-reinsurance-program