Frequently Asked Questions

Where does Regence stand on health care reform?

Regence strongly supports the long-term health care security and stability of all Americans, and we are committed to ensuring the new law is implemented successfully. For years, Regence has advocated for critical health care reforms including eliminating barriers to coverage, making medical care more efficient, and modifying the system to be simpler and more transparent. We are pleased these elements were included in the new law.

While we've made meaningful progress, much work remains, particularly as it relates to the ever-present challenge of rising costs. We will continue to work closely with lawmakers, community leaders and others to develop solutions for making health care more affordable for our members and their families. Regence has long been an advocate for reform. As we work to implement the new law, we will continue to stay thoroughly engaged.

When does the new law take effect?

The new law has many provisions, which are being phased in over time.

A preliminary set of changes takes effect for plans purchased or renewed after September 23, 2010. The Blue Cross and Blue Shield association has an interactive timeline that shows when parts of the law take effect.

Do health insurers have to accept everyone now?

The big changes in the law—the ones that could affect tens of millions of people—don't kick in until 2014. Some of those changes include the establishment of insurance marketplaces called Exchanges; rules requiring insurers to accept all applicants, even those with health problems; and an expansion of state Medicaid programs.

Is it true that everyone has to buy health insurance?

Not until 2014. Then, all Americans will be required to obtain insurance or face an annual penalty. There will be exemptions, e.g. based on income.

Who gets subsidized insurance?

Aid is available on a sliding scale based on the federal poverty level.

What does the new law mean for kids and families?

It will affect families differently, depending on their incomes, home states, and job situations. In general, the health care reform bill expands coverage for kids, adolescents, and young adults.

I have two children, both in their early 20s, graduating from college. They are not on my health insurance now. Once this law takes effect, can I put them on my policy?

Yes, you can add your children to your policy when your existing health plan renews. The federal reforms allow children to stay on family policies until age 26. No such requirement exists today, and many policies end dependent coverage before this age. Dependents wishing to enroll on their parents' individual policies after the law takes effect on September 23 will still need to go through underwriting -- the law makes them eligible but does not make their enrollment guaranteed.

I own a business. Am I now required to provide health insurance for my employees?

Starting in 2014, if you have more than 50 employees, and do not offer health insurance as a benefit, and at least one of your full-time employees gets a subsidy from the federal government to purchase health insurance on his or her own, you may be subject to a fee of $2,000 for every one of your full-time workers. (Company accountants take note: you are permitted to subtract the first 30 of your employees from that assessment.) Also, even if you do offer coverage, you might have to take some extra action to help any of your low- or middle-income workers who want to buy insurance on their own.

I have a small business. Can you explain the small business tax credits?

Retroactive for premiums paid beginning in January 2010, small businesses with the equivalent of 25 or fewer full-time equivalentemployees may get a federal tax credit of up to 35 percent of their premium costs if they meet the following requirements:

• The average annual wage is less than $50,000.
• The employer contributes at least half of the premium cost.
• The coverage meets minimum standards.

The IRS will administer this program. For information on the amount of the potential tax credit, how to count employees, and other details, consult your tax advisor or review the information posted on IRS.gov.

I'm over 65. How will the new law affect seniors?

Beginning this year, the law will make all Medicare preventive services, such as screenings for colon, prostate and breast cancer, free to beneficiaries.

The Medicare prescription-drug benefit will be improved substantially. This year, seniors who enter the Part D coverage gap, known as the "doughnut hole," will get $250 to help pay for their medications.

Beyond that, drug company discounts on brand-name drugs and federal subsidies and discounts for all drugs will gradually reduce the gap, eliminating it by 2020. That means that seniors, who now pay 100% of their drug costs once they hit the doughnut hole, will pay 25%.

And, as under current law, once seniors spend a certain amount on medications, they will get "catastrophic" coverage and pay only 5% of the cost of their medications.

Meanwhile, government payments to Medicare Advantage, the private-plan part of Medicare, will be frozen starting in 2011 and cut in the following years.