What are the requirements to meet ACA compliance?


Quick Answer

The Affordable Care Act requires all insurance policies comply with 10 essential benefits as dictated by the act itself, according to the U.S. Department of Labor. These benefits include insurance plans grandfathered in from before the passing of the act, to the elimination of dollar limits on essential health benefits.

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Full Answer

Other requirements of the act include that health insurance buyers not be excluded from the market due to pre-existing conditions, notes the U.S. Department of Labor. Young adults still in college or in the first few years of work now benefit from staying on their parents' coverage until the age of 26. Insurance plans must also eliminate excessive waiting periods and also cover individuals participating in clinical trials. The act imposes new limits on cost-sharing on the part of the insurance buyer, so that no one with a health care plan has excessive fees that cripple their finances.

Employers benefit from wellness program incentives, which have been increased to a maximum of 50 percent of an employer's cost when instituting a wellness program. While these make up the majority of the requirements for a health insurance plan to be ACA compliant, there may be variations depending on local and state regulations, reports the U.S. Department of Labor. Exhaustive advice concerning the nuances of the act should be sought out from legal counsel.

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