Additional protections that may apply to your plan include the requirement to provide coverage for certain preventive services (such as blood pressure, diabetes and cholesterol tests, regular well-baby and well-child visits, routine vaccinations and many cancer screenings) without cost-sharing, and coverage of emergency services in an emergency department of a hospital outside your plan’s network without prior approval from your health plan.
The Affordable Care Act also provides coverage options that allow you to maintain health coverage for you and your family. This page provides information on the Affordable Care Act to help you consider your options and make informed decisions, along with contact information if you have further questions.
Employers must provide notice to employees of coverage options. No later than October 1, 2013, employers will be providing these notices to current employees and to new hires within 14 days. If your employer offers a health plan to some or all employees, you will receive this notice. If your employer does not offer a health plan, you will receive this notice.
Option 1: Your employer planThe Affordable Care Act adds numerous protections related to employment-based group health plans. These include:
- Extension of Dependent Coverage to Age 26
- Pre-existing Condition Exclusion Prohibition
- Summary of benefits and coverage (SBC)
- Coverage of Preventive Services
- Essential Health Benefits
- Internal Claims and Appeals and External Review
- Medical Loss Ratio
- Wellness Programs
- Grandfathered Health Plans
- The Health Insurance Portability and Accountability Act of 1996 (HIPAA)
- The Consolidated Omnibus Budget Reconciliation Act (COBRA)
- HHS Bulletin Allowing COBRA Qualified Beneficiaries to Enroll in the Health Insurance Marketplace
- HHS Fact Sheet on Losing Job-Based Coverage
- The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA)
- Women's Health And Cancer Rights Act (WHCRA)
- Newborns' And Mothers' Health Protection Act
- Genetic Information Nondiscrimination Act (GINA)
- Your Health Plan and You - Know Your Health Coverage Protections
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- Protecting Retirement and Health Care Benefits After Job Loss | en español | 中文 | 한국어 | tiếng Việt | po Polsku
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- Conozca Sus Derechos de Beneficios de Salud
For more information about obtaining coverage through the Marketplace, visit www.healthcare.gov, contact EBSA electronically atwww.askebsa.dol.gov, or call the HealthCare.gov Help Line at 1-800-318-2596.
(305)310-5517 Toll Free: (877)365-7263