By Sept. 23, a wave of health reform provisions will take effect. But,according to a new phone survey from the National Association ofInsurance Commissioners, most consumers don't know exactly what'scoming.

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NAIC's survey foundwhen asked to choose from four dates for which the first healthcare reform provisions officially take effect, only 14 percent ofrespondents correctly identified Sept. 23, 2010.

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And when asked about the provisions that will take effect onSept. 23, most respondents were only in tune to things that affectchildren. Specifically, 72 percent knew that children withpre-existing conditions may not be excluded from coverage and 70percent understood that individuals up to age 26 may be coveredunder their parents' insurance.

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"Our survey findings are a clear indicator that most Americansare not aware of how soon some of the early health care changes mayimpact them," said NAIC President and West Virginia InsuranceCommissioner Jane L. Cline, in a statement. "It's essential forconsumers to understand what to expect and when to consult theirstate insurance departments for more information."

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The survey also found there's confusion surrounding health planmandates. Roughly half the respondents think employers with 50 orfewer employees have to provide health coverage by law, when infact those smaller companies have escaped the mandate. In fact,more than 16 million small business employees work in firms thatwill be eligible for tax credits under the Affordable Care Act tohelp offset premium costs, according to TheCommonwealth Fund.

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And again, roughly half of the respondents mistakenly thoughtall health insurance plans must cover preventive care and checkupswithout co-payment, when in fact, only new health plans must coverthese services; This provision doesn't apply to plans that areconsidered grandfathered - those in effect on or before March 23,2010 - unless those plans lose their grandfather status[see related: Survey: most health plans will lose grandfather status]

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However, those qualifying for Medicare will receive newpreventive care benefits that will include annual visits free ofco-payments, but this is not mandated for all health insuranceplans, according to NAIC.

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"The results show that while most consumers are well attuned toprovisions specifically affecting their children's health care,they do not grasp the overall reform framework," said Cline. "It'spromising to see this, but we feel it necessary for consumers tofully understand the changes and get informed about what toexpect."

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What about transitional plans (bought between March 23,2010 and Sept. 23 2010)?

  • Added protection from having insurancecancelled: An insurance company can't rescind your policyexcept in cases of intentional misrepresentations or fraud. If yourinsurer tries to rescind your coverage, it must give you 30 daysnotice so that you have time to appeal the rescission.
  • No pre-existing condition exclusions forchildren: If you have children under the age of 19 withpre-existing medical conditions, you can add them to your familyhealth insurance plan, and their application for coverage cannot bedenied as a result of a pre-existing condition.
  • Extended coverage for adult children: Adultchildren may qualify to remain on their parents' health plan untilage 26.
  • Lifetime coverage limits: No lifetime limitson the dollar value of those health benefits deemed to be essentialby the Department of Health and Human Services.

Mark your calendar for Sept. 23, 2010:

  • Dependents (children) will be permitted to remain on theirparents' insurance plan until their 26th birthday, and regulationsimplemented under the Act include dependents that no longer livewith their parents, are not a dependent on a parent's tax return,are no longer a student, or are married.
  • Insurers are prohibited from excluding pre-existing medicalconditions (except in grandfathered individual health insuranceplans) for children under the age of 19.
  • Insurers are prohibited from charging co-payments ordeductibles for Level A or Level B preventive care and medical screenings on all newinsurance plans.
  • Individuals affected by the Medicare Part D coverage gap willreceive a $250 rebate, and 50 percent of the gap will be eliminatedin 2011.The gap will be eliminated by 2020.
  • Insurers' abilities to enforce annual spending caps will berestricted, and completely prohibited by 2014.
  • Insurers are prohibited from dropping policyholders when theyget sick
  • Insurers are required to reveal details about administrativeand executive expenditures
  • Insurers are required to implement an appeals process forcoverage determination and claims on all new plans.
  • Indoor tanningservices are subjected to a 10 percent servicetax.
  • Enhanced methods of fraud detection are implemented.
  • Medicare is expanded to small, rural hospitals andfacilities.
  • Non-profit Blue Cross insurers are required to maintain a lossratio (money spent on procedures over money incoming) of 85 percentor higher to take advantage of IRS tax benefits.
  • Companies which provide early retiree benefits for individualsaged 55 to 64 are eligible to participate in a temporary programwhich reduces premium costs.
  • A new website installed by the Secretary of Health and Human Services will provideconsumer insurance information for individuals and small businessesin all states.
  • A temporary credit program is established to encourage privateinvestment in new therapies for disease treatment andprevention.

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