Health Care Reform Q&A With the VSCPA Insurance Center: Preexisting Condition Exclusions

Question: What do I need to know about interim final regulations released for preexisting condition exclusions, lifetime and annual limits, rescissions and patient protections.

Answer: On June 23, 2010, the Departments of Labor, Health and Human Services and Treasury released final interim regulations relating to preexisting condition exclusions, lifetime and annual limits, rescissions, and other patient protections under the Affordable Care Act. The Regulations were published in the June 28, 2010 Federal Register. The table below contains a brief description of each regulation, its effective date, and its application to grandfathered group health plans.

Regulation	Effective for Plan Years Beginning On or After	Applies to Grandfathered Group Health Plans?
Prohibition of preexisting condition exclusions or other discrimination based on health status	January 1, 2014, or for individuals under age 19, September 23, 2010	Yes
No lifetime or annual limits	September 23, 2010	Yes
Prohibition on rescissions	September 23, 2010	Yes
Patient protections	September 23, 2010	No

For more details on these final regulations, download the full pdf available on the VSCPA Insurance Service Center’s administrator, Dominion Benefits’, website.

Health Care Reform Q&A is facilitated by the VSCPA Insurance Center. Have a question? Leave a comment, or contact the VSCPA Insurance Center directly. This document is not intended to imply or provide tax or legal advice and is the VSCPA Insurance Center's current interpretation of the Health Reform Bill.