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Business Study - Healthcare Management

" as Secretary will define term. Any benefits that are not "essential" may have annual limits. When a plan covers dependents, an adult child (including a married adult child) must be allowed to receive coverage until the child turns age 26 (U.S. Department of Labor, 2015). There are no requirements to cover child of such a dependent child. A different allowance is offered in Internal Revenue Code Section 105(b), which is amended to permit an employee to exclude from gross income the value of employer provided health coverage to any child of a taxpayer who has not reached age 27 as of the end of the tax year. Similar changes were made for VEBAs and 401(h) accounts (Internal Revenue Service, 2015). The loss of lifetime maximum limits and the increase in adult dependent coverage by 4 years (or 5 years by I.R.S. standards) creates an obvious and immediate impact to the HMFC bottom line.
             Patient Protection and Affordable Care Act .
             If HMFC were to continue providing healthcare insurance coverage, there would be many more cost factors to consider than lifetime limits and adult dependent age limits. Just a cursory overview of several key considerations that would affect the value of the insurance provided to full-time company employees is:.
             Requirement to provide "Free Choice Vouchers" to employees who exceed a certain percentage of their annual household income (Section 10108).
             Requirement to accept any available doctor as primary for treatment (Section 10101).
             Requirement to include Emergency Services in the definition of "essential" (Section 10101).
             No authorization required for OB/GYN treatment for designated primary care provider (Section 10101).
             Addition of Clinical Trials coverage costs if being treated for cancer or any other life threatening disease (Section 1253 for effective date).
             Limits to waiting periods for treatment based on plan limits (Section 1201).
             No exclusion of pre-existing conditions in plan coverage (Sections 1201 & 10103).


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