Pre-existing Conditions
- Group Health Plans – Under current rules, insurers can exclude any condition treated in the past six months as a pre-existing condition. Effective January 1, 2010, that six-month lookback is reduced to 30 days. Insurers may only exclude that condition from coverage for a maximum of 3 months, 9 months for late enrollees.
- Domestic Violence – Group and Individual Plans may NOT treat domestic violence as a pre-existing condition
- Children with congenital disorders or deformities – Requires group and individual health plans to cover treatment for reconstructive surgical procedures, tumors, procedures for secondary conditions and follow-up treatment.
- Lifetime Aggregate Limits are eliminated from group and individual health plans, effective January 1, 2010.
Retiree Benefits
Prohibits reduction of benefits promised under group health plans to retired participants, also establishes a re-insurance plan for existing retiree benefits.
Wellness Grants
Awards small employers (assume 50 or fewer employees for now, specific definition to be determined) a grant of 50% of the cost of offering a qualified wellness program to employees for up to 3 years.
State Grants
States which implement innovative and cost-saving programs are eligible for Federal grants to assist with funding.
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