Section 102 Health Care Plan

Upon reading  section 102 of the 1200 page health care plan it can be ascertained that an employer’s  health care plan will be null and void if,

  • the employer hires another person
  • the employer offers  benefits not offered before ( in other words, the employer can not enhance the employees health benefits with new treatments or lower the cost for the employees)

thus the employees will revert to the govt. health care plan

Here is section 102

Section 102, “Protecting the choice to keep current coverage.” It states:

(a) Grandfathered Health Insurance Coverage Defined — Subject to the succeeding provisions of this section, for purposes of establishing acceptable coverage under this division, the term “grandfathered health insurance coverage” means individual health insurance coverage that is offered and in force and effect before the first day of Y1 if the following conditions are met:

(1) LIMITATION ON NEW ENROLLMENT —

(A) IN GENERAL — Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1.

(B) DEPENDENT COVERAGE PERMITTED — Subparagraph (A) shall not affect the subsequent enrollment of a dependent of an individual who is covered as of such first day.

(2) LIMITATION ON CHANGES IN TERMS OR CONDITIONS — Subject to paragraph (3) and except as required by law, the issuer does not change any of its terms or conditions, including benefits and cost-sharing, from those in effect as of the day before the first day of Y1.

(3) RESTRICTIONS ON PREMIUM INCREASES — The issuer cannot vary the percentage in-crease in the premium for a risk group of enrollees in specific grandfathered health insurance coverage without changing the premium for all en-rollees in the same risk group at the same rate, as specified by the Commissioner.

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~ by riffenberg on September 7, 2009.

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