Announcements & Features: health care reform

frequently asked questions

Page last updated: Tuesday, 14-Sep-2010 15:11:33 EDT

Now that health insurance reform legislation has been signed into law, we join other U.S. employers in anticipating the detailed regulations that will follow. No impact on health benefits at the University of Michigan will be felt in 2010. Any changes that affect us for 2011 and beyond will be broadly communicated once the government regulations are issued.

The most immediate changes contained in the legislation do not affect U-M because they focus primarily on tax relief for small businesses that provide health insurance to their employees. Because the university has a long history of valuing our health benefits, we already comply with a number of the provisions of the Patient Protection and Affordable Care Act. Yet, we clearly expect some changes, so we will continue to study the progress of this legislation and the eventual regulations for employers so that the university community is both prepared and informed.

Below are answers to some of the most frequently asked questions.

Can I add my 25-year-old child back onto my U-M medical plan? I heard that health plans will be required to allow young adults to stay on their parents' insurance until age 26.
No, if your child turns 25 this year, they can't be added back onto your plan. This health care reform provision won't affect us until the next plan year, which starts on January 1, 2011. For 2010, U-M eligibility requirements for dependent children do not change.

You can add your eligible children to your benefits during Open Enrollment, October 25 - November 5, for coverage starting 1/1/11. Open Enrollment will allow the addition of 19-26 year olds on all plans if they aren’t eligible for coverage elsewhere. Those under 26 may be newly eligible even if they are married or not principally supported by their parents. Regulations require a special 30-day enrollment period to add eligible young adults to your coverage. For your convenience you are encouraged to add your eligible 19-26 year old children to your coverage online during Open Enrollment. You will also be able to enroll your children by paper form during the special enrollment period that will coincide with Open Enrollment in the fall.

Does health care reform affect the U-M Dependent Benefits Eligibility Audit that is currently underway?
No, the reform bill has no impact the Dependents Benefits Eligibility Audit. The benefits audit is designed to confirm that enrolled dependents are qualified for coverage under the current U-M benefits eligibility requirements.

Will my U-M benefits change in 2010?
Your U-M benefits will not change in 2010. Any changes that take effect in 2011 or beyond will be communicated in advance of the effective date. You will also be notified of any changes taking place in 2011 prior to the Open Enrollment period this fall.

The health care reform bill will prevent plans from denying coverage due to pre-existing conditions. Does this affect U-M plans?
That change won't affect U-M plans. None of the University of Michigan medical plans exclude faculty, staff, or dependents from coverage due to pre-existing conditions.

Is there a provision for appealing insurance denials of coverage?
The health care reform bill does require all new health plans to allow consumers to appeal insurance company denials of coverage and get an independent review of their case. All U-M health plans currently provide a process for requesting a review.

Can I select my own primary care doctor?
All new health plans will be required to let you pick our own primary care physician (PCP). Women will be allowed to visit their ob-gyn without getting permission from their insurance company first, and all patients will be guaranteed access to emergency care. The U-M health plans already allow you to select your own participating PCP, allow women to visit their ob-gyn without referral, and all plan members have access to emergency care, even while traveling.

How soon will the reform measures take effect?
Changes are to be phased in over time from now through 2018. The federal government will issue regulations that employers and health insurance companies will use to comply with the requirements. The Benefits Office will study the regulations and changes that impact U-M faculty, staff, retirees or dependents will be communicated in advance of any change taking effect.

Still have questions? Please contact the HR/Payroll Service Center at (734) 615-2000.