IQ expert Jason Beans: State health insurance exchanges may be worth a look

Q: This new health care reform law is pretty confusing. I’ve got health insurance through my employer. What do I need to know about health care reform that will affect me?

A: The effect you’ll see depends largely on the company you work for now. Your employer will be deciding whether to continue paying for employee health insurance or to simply pay the fine for not providing insurance. If the latter happens, then you’ll be left to shop for coverage through what are known as health insurance exchanges.

If you work for a small company, you may feel the effect more, partly because the fines for not offering coverage are low. Small businesses that already are struggling to break even will be left to make an economic choice, not a “good employer” choice.

If you work for a midsize to large employer, this scenario could happen to you as well. If you currently have poor coverage, you’ll definitely want to take a look at the state-run health insurance exchanges — marketplaces that will offer several insurance options. All arrows point to more people — even those with employer-covered health insurance — checking out the exchanges out of necessity.

Health care reform changes that already are in place include:

• An employee’s son or daughter may be covered under family insurance until the child is age 26, even if the child is married.

• Children with pre-existing conditions cannot be excluded from coverage.

• Insurance must cover preventive care services.

• No lifetime limits are imposed on out-of-pocket patient costs, with annual limits in effect only through 2014.

• Employer-provided insurance may not discriminate among employees. This prevents employers from providing enhanced insurance benefits based on an employee’s length of service.

• Over-the-counter drugs purchased through flexible spending accounts (FSAs) or health savings accounts (HSAs) aren’t counted as medical expenses, unless your doctor prescribes them.

• You’ll be slapped with a 20 percent penalty for early withdrawals from HSAs for non-medical purposes, up from the previous penalty of 10 percent.

Jason Beans is CEO of Chicago-based Rising Medical Solutions, a medical cost containment/care management company serving the workers’ compensation, group health, auto and liability markets. Beans founded Rising in 1999. Since then, Beans has received a number of honors, including Business Council Advisory Man of the Year and Midwest finalist for Ernst & Young Entrepreneur of the Year. Rising has appeared several times on the Private Company Index’s Top 10 Growth list and Inc. magazine’s Inc. 5000 list.

Beans earned a master’s degree from MIT’s Entrepreneurial Masters Program and a bachelor’s degree in finance from Boston College.

For more information, visit www.risingms.com.

If you have a health insurance question for Jason Beans, please send it to john.egan@insurancequotes.com.