Principles of Risk Management and Insurance, 13th Edition

Affordable Care act and Group Medical Expense Insurance

Most provisions of the Affordable Care Act that affect group medical expense plans are now in effect. Although these provisions have already been discussed in Chapter 15, certain provisions are repeated here because of their importance and direct impact on group medical expense plans. These provisions include the following:

• Certain insurance practices prohibited. The Affordable Care Act (ACA) prohibits insurers from engaging in certain practices harmful to insurance consumers. Prohibited practices include the following:

  • – Applicants for medical expense insurance have guaranteed issue and availability of coverage and cannot be turned down or rated up regardless of their health and medical ...