Employees will see changes in 2011 health benefits

The Atlanta Journal-Constitution: "Workers who have received their annual enrollment packets for insurance benefits" should expect slight changes to their plans this year due to the health care overhaul. Most employees can expect to pay more next year, due in part to the 1 to 2 percent increase in insurance costs brought about by the law. The changes expected this year: adults younger than 26 can stay on their parents' health insurance plan if they lack coverage through work; children under 19 can't be denied due to a pre-existing condition; preventive care must be free; "insurers may no longer impose lifetime dollar limits on essential health care benefits, such as hospital stays;" and consumers are guaranteed the option to choose their own primary care doctor from their plan's network (Teegardin, 11/15).

The (Cleveland) Plain Dealer lists the changes and adds some tips for consumers, including: "Watch out for hidden costs. Health reform requires insurers to spend between 80 percent and 85 percent of premiums on medical expenses or issue rebates to enrollees. The trend is for carriers to make increases in other areas. Out-of-pocket expenses could rise by more than 12 percent, according to eHealthInsurance.com. ... Consider spouse's plan. Couples should review whether to remain on the same plan. Employers are increasingly offering fewer benefits to spouses or implementing increasing fees for spouses to join plans. It may be cheaper for spouses to get coverage through their employers" (Perkins, 11/13).

KWCH (Wichita, Kansas) outlined additional changes: "Through Dec. 13, 2013, employers can received tax credits of up to 35 percent of the cost of providing health insurance for their employees if: The employer covers at least 50 percent of health insurance costs for some or all employees. The employer has fewer than 25 full-time employees.  The average annual wage of those employees is less than $50,000 per person. ... [and] Early retiree reinsurance. Federal dollars are available to help employers maintains coverage for retirees age 55 or older (and their dependents) who are not yet eligible for Medicare" (Sewell, 11/14).

MarketWatch: "Workers still deciding their 2011 health benefits may want to factor new flexible-spending rules into their calculations. ... Starting Jan. 1, consumers who want account reimbursement will need to have a doctor's prescription when they purchase a drug or medicine that's sold over the counter." Items such as eyeglasses, contact-lens solution, bandages, dental care, and test kits won't be affected by the new prescription requirement" (Gerencher, 11/15).

Related, earlier KHN story: OTC Medicines Cut From 2011 Flexible Spending Accounts (Andrews, 11/9).

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.