Effects of Health Care Reform

Decisive action controls costs, ability to remove ineligible dependents

The recently passed Patient Protection and Affordability Act (PPACA) will undoubtedly continue to bring major changes to employer-sponsored health plans, including significantly higher costs.

It is essential for employers to fully prepare and react to changes as quickly and decisively as possible to help control health plan expenses.

Dependent eligibility audits remain one of the best tools for reliable cost containment by preventing unnecessary and fraudulent claim expenditures. Eligibility management is more critical than ever due to PPACA Sec. 2712- Prohibition and Recission. This section of the PPACA prohibits the rescinding of health insurance for any reason other than "fraud" and "intentional misrepresentation of material". Proving that an employee has committed fraud can be extremely difficult, and will only become more challenging in the future.

Aon Hewitt believes employers should retain their right to cover only eligible participants as intended. Health care reform will continue to evolve over the coming years, and employers who are proactive in closely managing their plans will be able to mitigate some of the unwanted and fraudulent costs that result from covering ineligibles.

For more details, please review the Aon Hewitt White Paper on this subject.