Whether you agree or disagree with the Affordable Care Act (Healthcare) there are many provisions that have yet to be fleshed out.
One in particular, “The Class Act” (Community Living Assistance Services and Support program), is a little discussed part of the Affordable Care Act of 2010.
What is the class Act?
The devil is in the details as they say, in other provisions of the health care bill it has yielded up to 400 pages of interpretive regulation for each actual page in the original bill, so it is not unreasonable to believe this piece of the act will follow suit.
It will be developed by fiat under the auspices of Health and Human Services (HHS) over the next few years, creating a new voluntary government program under which individuals will pay monthly premiums.
While described as Long Term Care it is primarily designed as a program to provide future assistance to the working class blue collar who may become disabled during their lives and may need extended care.
The plan will be a Guaranteed Issued (GI) based product, which means that structually there are no medical questions and no one can be turned down for a condition.
In order to remain solvent this type of contract has to charge a higher premium than one that medically underwrites. There is a tendency for sicker individuals to gravitate towards this type of product as they have been excluded from the private market.
When will it begin?
Provisions will start to materialize effective in 2011 with many details to be worked out in 2012 as prescibed . Many experts feel this is an unreasonable expectation and that final implementation will be postponed until 2013.
What are the benefits?
Much of the Benefits and premium cost lie in the hands of Kathleen Sebelius the Secretary of HHS. As was the case in most of the 2000+ pages of this legislation Congress was remiss in passing off hard choices to department secretaries.
It is doubtful that there will be any optional features, such as inflation protection, at least initially.
Since this program is going to be modeled on the Medicare and Social Security deduction platform, employers will be tasked once again with yet another set of regulations to interrupt, educate their employees and leave sufficient time to withhold premiums.
In order to meet congressional mandatory financial sustainability of the plan, there is a 5 year waiting period, from the time premiums are paid until the employee is eligible to receive benefits due to a sickness or illness. This is a very shrewd way to handle the thorny issue of solvancy for the plan that Congress has mandated fiscally sound for 75 Years.
Premiums may be adjusted yearly.
The “Opt out” feature is an option to enroll. Congress has stipulated if you have not specifically said no to “opt out” then you have “opted in” and premiums will be deducted. If a private insurer tried this approach they would be pilloried.
So where does that leave you?
This is why the general public needs professional, deidcated insurance agents, combined with strict commonsense oversight, to help you sort out these complex issues. Whether an individual, privately run Long Term Care Plan is the correct one for you is not explained with graphs and spreadsheets, but from the heart. A good agent and the client, in consultation with other professionals, will know when a plan solution is right based on your needs and desires. That makes everyone sleep a little better.
