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Health insurance will change for many workers

Although the recently passed healthcare legislation will most dramatically affect Americans who don’t have health insurance, most nonelderly Americans -- about 160 million -- are expected to keep getting coverage through their employers.

But workers could see some changes as a result of the new healthcare law.

Will my employer have to offer any new benefits?

Yes. Beginning as soon as this fall, companies that offer health plans will have to allow employees to keep their children on their plans until the children are 26 years old.

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Employers will also be prohibited from putting lifetime caps and some annual caps on benefits for their employees.

Companies that begin offering new health plans will be subject to other new requirements, including a mandate starting in 2014 to provide an “essential benefits package” that is expected to be more comprehensive than a typical employer-provided plan. (Employers with existing health plans would be exempt from this new requirement.)

Will my employer be able to scale back benefits?

Yes. Most employers that now offer health plans would be able to change the kind of medical benefits they offer their employees, potentially increasing co-payments and deductibles or reducing what their plans cover.

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What will happen to my premiums?

That’s difficult to say, but most are expected to continue to increase in coming years.

The nonpartisan Congressional Budget Office estimated that by 2016, an average individual policy provided by a large employer would cost about $7,300 a year (and slightly more for workers at small firms). An average family policy would cost about $20,300 a year (and slightly less for workers at small firms). As now, those premiums would probably be split between employers and employees.

By comparison, in 2009, the average employer-provided individual policy cost $4,824 a year, and the average family policy cost $13,375, according to an annual survey by the nonprofit Kaiser Family Foundation.

Will I see other changes to my paychecks?

Beginning next year, employees will be automatically enrolled in a new insurance program, known as the CLASS program, to cover long-term care, unless they choose to opt out. The program is funded by a payroll deduction.

Beginning in 2014, employees who participate in wellness programs or meet health standards could also get up to a 30% break in their premiums, if their employer chooses to offer this incentive.

Will I have any more choice in health plans?

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You might. States are slated to set up regulated insurance marketplaces, or exchanges, in 2014, where insurers will offer plans that will have to meet basic standards set by the government. These were primarily designed to help people who don’t get benefits at work shop for a health plan.

But employers with fewer than 100 employees would be allowed to enter these exchanges, potentially giving their workers a wider choice of plans than many have now. States could allow larger employers to enter these exchanges beginning in 2017.

noam.levey@latimes.com


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