Archive for July, 2010

Medical Tourism Association Announces Strategic Initiatives for Much Awaiting Global Healthcare & Medical Tourism Congress 2010

July 20th, 2010 No comments

The Medical Tourism Association, known for setting trends in the industry, announces new strategic initiatives under the theme progress in motion for global healthcare stakeholders, allowing them to discover & learn about intense topics of medical tourism, extending networking opportunities enhanced by dedicated sessions and creating knowledge sharing possibilities between government, insurance, healthcare and tourism professionals during THE World Medical Tourism & Global Healthcare Congress, taking place in LA from September 22nd – 24th.  

“We recently announced our extensive agenda, today we are announcing the list of incredible speakers, coming exclusively with the sole purpose of providing a learning platform for industry stakeholders. We are particularly encouraged at the number of high level government officials who are attending the ministerial summit which indicates growing support from all sectors for medical tourism initiatives, especially ministers of health, tourism and economic development,” said Jonathan Edelheit, CEO of the Medical Tourism Association.

MTA team worked relentlessly this year to identify and invite top government officials from across the world, eminent professionals from US & International Insurance Companies, alongside some of the largest US and International Employers, on another hand, leading medical tourism experts and top global healthcare providers are revisiting the congress.

“Though we have received tremendous responses, we are receptive to have more top-notch experts and professionals to utilize the platform to share their knowledge, experience and expertise,” added Edelheit, inviting leading speakers to join congress by submitting white papers at

The congress is the biggest networking opportunity platform in the world for medical tourism and global healthcare related affairs. The addition of the “Buyers of Healthcare VIP Program” is also a unique feature which was added to create more interesting and one on one business meetings for all delegates and sponsors, bringing up to 200 employers, insurance companies, agents and medical tourism facilitators who are involved in or interested in patients traveling across borders for healthcare.

“Networking is the spirit of our congress. We realize that social media and electronic channels can’t replace one-on-one meetings. Last year we got incredible responses and many delegates mentioned networking alone provided ROI, while learning & sharing experience was nothing but overwhelmingly a delightful experience,” says senior meeting manager Silvana Maldonado, working exclusively for networking and meeting sessions.

While extensive agenda, green healthcare initiative, learning opportunities, networking possibilities and knowledge sharing are base of the congress, seasoned speakers are the main focus which makes this a comprehensive Medical Tourism Mecca gathering.

Some of our seasoned speakers are as follows:

Karen Beyer – Director of Global Benefits, General Electric

Mr. Jose M. Loaiza – Senior Network Manager, Blue Shield of California

Premier W. McKeeva Bush – Premier, Cayman Islands

Joanne Armenio – Director, International Benefits, Kraft Foods

Bob Ihrie – Senior VP of Employee Rewards and Services, Lowe’s Companies, Inc.

Luis Fernando Moreas – Secretary of Tourism, Porto Alegre Brazil

Kathy Clark – Compensation & Benefits Analyst, Blackbaud, Inc.

Anthony Amato – VP Compensation & Benefits, Discovery Communications

Kevin M. Fickenscher, M.D., CPE, FACPE, FAAFP – Chief Strategy and Development Officer, Dell Services

H. E. Mr. Nasser Al Budoor – Director, Ministry of Health, UAE, International Relations & Health Affairs and Director of Health Minister’s Office

Cheryl Matheis – Senior Vice President for Health Strategy, AARP

Laila Al Jassmi – CEO, Clinical Support Services Sector, Dubai Health Authority

David M. Cheek – Vice President of Sales, Pan American Life Insurance Group

Dr. Shetty – Heart Surgeon of India & Founder of Hospital Investment Project, Cayman Islands

Michael Bertaut – Senior Healthcare Intelligence Analyst, Blue Cross and Blue Shield of Louisiana

Jeff A. Argotsinger – Director, Business Leader Medical Expense Group, Swiss Reinsurance Company

Dr. Hisham Diwani – General Manager, Health Insurance, Ministry of Health Syria

Bavdeep Singh – CEO, Fortis Healthcare India

Emilio M. Williams – Managing Director, Johns Hopkins Medicine International

Dr. Rick van Pelt – Director Global Programs, Partners Harvard Medical International

Mark Scotland – Minister of Health, Cayman Islands

Jonathan Hart – Chief Medical Officer, International Medical Group

Pamela Frank – International Health Services Coordinator, Children’s Hospital of Boston

Fred Hagigi – Director, Executive Education Programs Professor of Health Services, UCLA School of Public Health

MaryBeth Kramer – Sr. Manager, Global Benefits and HR Services Compensation and Benefits, Verisign

Shady Fawzy Nawar – Assistant Vice President – Provider Management, Qatar Insurance Company-Doha

Arthur L. Diskin, MD, FACEP – Vice President and Global Chief Medical Officer, Royal Caribbean, Celebrity and Azamara Club Cruises

Martha Turnbull – Travel Health Insurance Association of Canada

Linda Cote – AGB Sales Director Pacific Region, Aetna

Dr. Jeannette Takemura – Dean of School of Social Work, Columbia University

Alexander Sander Domaszewicz – Principal and Senior Consultant, Mercer Health & Benefits Services

Robert S. Shestack – WBC, Managing Director, National Sales Leader, Employer Benefits Business, Marsh U.S. Consumer, a service of Seabury & Smith, Inc.

Brad Cook – International Patient Department, Hospital Clinica Biblica, Costa Rica

Renee-Marie Stephano – President, Medical Tourism Association

Jonathan Edelheit – CEO, Medical Tourism Association

Ralph Lawson – Executive Vice President and Chief Financial Officer
Baptist Health South Florida

Greg Carlson – Assistant Professor, University of Alabama, Department of Health Services

Jason B. Krouse – Executive Vice President, Univers Workplace Benefits

William Cook – International Patient Department, Hospital Clinica Biblica

Dr. Prem Jagyasi – MD & CEO, ExHealth Dubai

Tom O’Hara – President, Surgical Trip LLC

Dr. Antonia Arnaert -Vice-President, Debson Medical Tourism

Dr. Narottam Puri – President, Medical Strategy & Quality, Fortis Healthcare

Wouter Hoeberechts – CEO, WorldMed Assist

Doug Wojcieszak, Founder, Sorry Works!

Richard Polak, President & CEO, IBIS Advisors

Derrell Connor, Account Executive, M3 Insurance Solutions for Business (M3)

Tom Hamilton – President, Carolina Benefit Designs

Daniel Friedland – MD, Founder & CEO, SuperSmartHealth

Jason Woods – Fairmont Specialty Group

Sonia Roschnik – Operational Director, NHS Sustainable Development Unit, UK

C. Duane Dauner – President, California Hospital Association

Stephen Hartigan – Chief Executive Officer, InterGlobal Insurance Company Ltd. (IGIC)

Peter Lozier – Executive Vice President Sales, Marketing and Provider Relations, CMN Inc.

Dr. Myles Druckman – Vice President Medical Services, Americas Region
International SOS Assistance, Inc

Dean Stone – Manager Workers Compensation and Governance, National Australian Bank

Stuart Rowley – CEO, Prince Court Medical Center, Malaysia

To view a full list of speakers please CLICK HERE or go to

Join us for the VIP After Party

The World Medical Tourism & Global Healthcare Congress is also known for its networking cocktail receptions following the general sessions. On Wednesday, September 22, 2010 all registered delegates will be invited to share in an entertainment filled networking session jointly held with the Employer Healthcare Congress where up to 1000 employers, insurance agents, brokers, consulting firms and healthcare leaders will finishing up their three day congress event on the Green Circle Terrace. For more information about the VIP After Party, please go see the video at  

Additional Giant Leaps for 2010

The World Medical Tourism and Global Healthcare Congress includes two additional conferences which are the Expatriate Healthcare, Travel Insurance and Global Health Insurance Conference,  and the Sustainable Healthcare and Hospital Development Conference, Speakers listed above are from all three conferences.

The Medical Tourism Association™ (Global Healthcare Association) is the international non-profit trade association for the medical tourism and global healthcare industry made up of the top international hospitals, healthcare providers, medical travel facilitators, insurance companies, and other affiliated companies and members with the common goal of promoting the highest level of quality of healthcare to patients in a global environment.  

Marketing & PR by ExHealth /  

For more information, please contact

For more information please call USA 001.561.792.6676
or email Amelia Fernandez
[email protected]

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Health Insurance Carriers already sending out notices to Insurance Agents about Reduced Commissions

July 16th, 2010 No comments

Health Insurance Agents around the country have already started to get “Vague” letters about reduced commissions that will be happening in the next few months. It focuses on individual policies now, but reference employer group commissions being effected also because of the minimum loss ratios. Some agents are reporting rumors of commissions on individual policies going currently from 22% to 28% being possibly reduced to FIVE PERCENT COMMISSION. Months ago I warned everyone this was going to happen. No one is talking about this everyone is being quiet. What are your thoughts?

Also, this is the real reason everyone needs to attend the 2nd Annual Voluntary Benefits & Limited Medical Conference,, September 20-22nd, 2010 in Los Angeles, CA. Employers, Agents, industry professionals all need to know how healthcare reform negatively affects them, and then find out what are new opportunities under healthcare reform that are positive.

Don’t wait until it’s too late to do anything.

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Editor Renee-Marie Stephano hits controversial topics for couple of years

July 8th, 2010 No comments

Around the World and Back Again ~ Medical Tourism Magazine Celebrates 3rd Year

July 7, West Palm Beach, Florida – Many publications have come and gone as the Medical Tourism Association approaches the 3-year anniversary of Medical Tourism Magazine, the only printed and online publication in the industry. Speaking on behalf of contributors and members at large, President of the Medical Tourism Association and Editor-in-Chief Renee-Marie Stephano reflects on where we have been, where we are and where we are headed.

“Over the years, we have covered far-reaching topics ranging from marketing medical tourism programs, innovative medical advancements, global health insurance to sustainability programs. In this upcoming issue, we are addressing anextremely important topic ~ that of global events affecting medical travel, like healthcare reform,” said Renee-Marie Stephano.

In fact, on this anniversary date, the Medical Tourism Association is also pleased to announce the official release of the Medical Tourism Magazine’s Issue 16 featuring articles such as “Medical Tourism ~ A Solution for Healthcare” and “Healthcare Reform and Emerging Benefit Program Opportunities.” Read now at,

“The Medical Tourism Magazine keeps improving with every issue,” says Kenneth Mays of Bumrungrad Hospital. “It has become an invaluable source of insights about this growing healthcare niche. The magazine covers and collects topics of importance and significance to the medical tourism sector from diverse sources all over the world.”

Here at the Medical Tourism Magazine we make every effort to cover all aspects of the medical tourism industry, missing nothing of importance or relevance. If it’s relevant, we cover it in a timely fashion. As this industry continues toexpand, we stay on top of the collaborations, innovations and transformations as they occur. The Medical Tourism Magazine is your go-to source; the location of important information about this industry. Also, The Medical Tourism Magazine is your voice in the industry as we welcome contributions for print.

The Medical Tourism Magazine offers both printed and online advertising as well. It also boasts a Social Media package that encompasses all aspects of Social Media marketing into a competitively priced package, aimed at attracting your target audience. In the form of a blast to your target audience with press releases, insider blogs and various postings on all social media networks; MTA has access to a comprehensive social network for medical tourism enthusiasts in the MedicalTourismCity.  MTA welcomes inquiries about our prestigious Guest Blogs, which are offered directly on  

MTA also offers the unique option of videos, including patient videos, which spotlight your international hospital as a leader in a particular medical procedure through the eyes of a patient’s experience! For more information, visit:

The Medical Tourism Magazine’s printed version on average is distributed to over 90 countries around the world in all 5 regionsinclusive of thousands of International Hospitals, International Health Insurance Carriers in the Middle East, US, UK and Canada, healthcare providers throughout the world, the travel industry, potential medical tourism patients considering going overseas for surgery, and anyone with an interest in the industry. The magazine is alsodistributed to a majority of the health plans which administer Self Funded Employer health plans in the U.S. Medical Tourism Magazine can be read at

Original Press Release available at:

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Employer Healthcare and Benefits Conference to Address Challenges and Opportunities for Employers facing rising insurance costs

July 8th, 2010 No comments

Employers and Insurance Leaders gather at large to discuss opportunities and challengesin offering health insurance and employee benefits in today’s economic climate of healthcare reform during the Employer Healthcare Congress September 20-22nd, 2010 in Los Angeles.

Employer provided health insurance and employee benefits face tremendous challenges in the future as the cost of insurance increases and employers fight off the economic recession. These challenges emerge with voluntary benefits, worksite benefits,self funded healthcare, workers compensation benefits, and corporate wellness benefits. Healthcare Reform places even more of a burden on employer groups and is estimated to increase the cost of providing healthcare benefits to their employees and plan members. Stakeholders gather together work towards solutions to managing the employee benefits they offer their employees.

Bob Trujillo, Program Director of Human Resources for the American Bar Administration said, “In order to meet the challenges of the current financial climate while balancing employee retention and recruitment, human resource professionals are faced with coordinating a new and innovative structure to their benefit plans. This conference is a great launching pad for sharing and developing new approaches toward our benefit packages.”

Some of the speakers for the Employer Healthcare Congress are:

Brady Jensen, Group Manager, Global Benefits, Microsoft Corporation

Colleen DePadua, Manager of Group Insurance,Black & Decker

Faye Saenz, Director of Employee Benefits, GameStop Corp.

Christina Harmon, Director of Benefits Administration, Ruby Tuesday 

Bob Ihrie, Senior Vice President of Employee Rewards and Services, Lowe’s Companies, Inc.

Avi Smith, Benefits Manager, B&H Photo

Susan Hannegan, Health Management Program Manager, Jack in the Box

Jacqueline Madrigal, Benefits Manager, American Apparel

Robin Lears, Benefits Administrator, United States Olympic Committee

Pamala Grove, Director of Benefits & HR Operations, Land O’ Lakes Inc.

PaniTademeti, HR Manager- Total Compensation, Office of State Personnel, North Carolina

Vicki Robinson, Manager, Insurance Services Division, City of Las Vegas

Annie Leko, Honeywell

Randy Moon, Vice President of Global Compensation & Benefit, Archer Daniels Midland (ADM)

Dr. Joseph P. Annis, Secretary, Board of Trustees, American Medical Association

Bernie C. Knobbe, Vice President, Benefits, ACS, a Xerox Company

Colleen DePadua, Manager of Group Insurance for Black and Decker, said, “The Conference 2010 will be a great opportunity for employers to discuss the advantages and disadvantages of self-funding. With national healthcare reform passed and affecting all plans regardless of funding, it is important for self-funded employers to understand those obligations. This conference will be an excellent forum for the exchange information and ideas.”

The Employer Healthcare Congress which is one of the largest Employer Healthcare Conferences in the country,  The healthcare conference is made up of four conferences, The Corporate Wellness Conference,, the Self Funding Employer Healthcare and Workers Compensation Conference,, the Voluntary Benefits and Limited Medical Conference,  and the National Healthcare Reform Conference,

The conference has implemented a VIP buyers program that will cover the travel expenses and bring in employers who have voluntary benefits programs in place or are interested in implementing voluntary benefits.

Robert Davenport, the Wellness Manager for theNASA/Johnson Space Center said, “The Conference is a tremendous opportunity for professionals in the wellness industry to exchange ideas and learn tried and true practices of other companies navigating the health and productivity management challenges faced by all organizations today. I look forward to sharing my experiences and challenges with attendees and applying solutions gathered from this meeting in my organization.”

Jonathan Edelheit, manager of the Employer Healthcare Congressadded, “This conference will bring together all the senior leaders in employer provided benefits to share their knowledge and collaborate on what challenges and opportunities the industry faces.There is no other employer health insurance conference like it.”

The conference is sponsored by the Self Funding Employer Association (SFEA), and the Self Funding Magazine, The Corporate Health and Wellness Association,, the Corporate Wellness Magazine,, the Voluntary Benefits Association, and the Voluntary Benefits Magazine, and the National Healthcare Reform Magazine,

Sarah Hunt
Senior Meeting Manager
[email protected]

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Medical Tourism Conference Releases Extensive Agenda to TargetEmerging Opportunitiesfor Global Healthcare Services

July 6th, 2010 No comments

Medical Tourism Conference Press Release 7/6/10

Medical Tourism Conference Releases Extensive Agenda to TargetEmerging Opportunitiesfor Global Healthcare Services

InternationalMedical Tourism Key Stakeholders gather to discuss opportunities and challenges of Inbound and Outbound Healthcare, bringing future trends to the forefront of discussion during the 3rd annual MTA World Medical Tourism and Global Healthcare Congress, September 22nd-24th, 2010 in Los Angeles.

The Medical Tourism and Global Healthcare industry represents an over forty billion dollar industry with millions of patients traveling each year for medical care. The industry faces many challenges, such as the increased competition of new countries and hospitals marketing their services, an economic recession and meeting the demands of a greater educated base of patients. The medical tourism industry also faces new opportunities in the form of healthcare reform in the US, the emergence of more insurance companies and employers in the US implementing medical tourism, and international insurance companies implementing global health insurance policies which let their clients travel anywhere in the world for medical care. As the medical tourism industry grows at thirty five percent each year, as estimated by Deloitte, for the next several years many new opportunities will emerge for the industry participants.

“The healthcare organizations in countries promoting medical tourism are improving the quality of the health care of their organizations in terms of services provided and accreditations. Investors are building newer, cutting edge hospitals as global competition increases and these facilities are trying to supply the high demand of new patients,” said Renee-Marie Stephano, President of the Medical Tourism Association, Chief Editor of Medical Tourism Magazine and Health Tourism Magazine. “This is why the sharing of information about improved healthcare infrastructure and sustainable healthcare programs becomes essential and will benefit the local population by providing greater access to the latest cutting edge medical technology, e-health and telemedicine,” she added.

Some of the emerging trends to be covered during the congress will include ~

• The Mystique of US Healthcare Reform for International Patients
• Setting up Aftercare and Aftercare Networks
• US and International Employers Case Studies on Implementing Medical Tourism into Employer Sponsored Health Insurance Plans
• Creating the Link Between Facilitators, Hospitals and Insurance Companies
• Public and Private Sector Collaboration ~ Prevention of Two Tiered Markets
• Patient Safety in Cross Border Healthcare ~ Inbound & Outbound Care
• Reinvesting Medical Tourism Dollars in Local Population Projects
• Sustainable & Green Hospital Development and Healthcare Development
• Expanding Role of E-Health in Medical Tourism and Global Healthcare
• Baby Boomer Healthcare and Retirement Living
• Providing Effective, Quality Healthcare to Expatriates

“When countries embark on building, marketing, and fulfilling medical tourism options for a regional and global community; the risk of a two-tiered system can result in undesirable and unintended consequences. Keeping and establishing a quality focus on healthcare services for all will become increasingly more important for a sustainable healthcare system,” added Stephano.

The extensive new agenda includes dedicated times for networking meetings, dedicated times for general sessions and dedicated times for exhibit hall hours so there is little to no overlap between different events at the congress. The new agenda can be seen at  The new speakers for the medical tourism and global healthcare conference can be seen at

The conference will also have a focus on bringing in employers, insurance companies and governments who deal with international healthcare issues and employees and patients on a global basis. “The ability to access quality, cost-effective health care on a worldwide basis is critical to the success of any company with a global strategy for sourcing employees and/or providing services,” said Arthur Diskin, Vice President and Global Chief Medical Officer, Royal Caribbean, Celebrity and Azamara, who will be presenting at the Congress.

The 3rd annual MTA World Medical Tourism and Global Healthcare Congress, organized by the Medical Tourism Association, and the Medical Tourism Magazine, will bring together up to 2,000 of the most senior level healthcare, leaders, employers and insurance industry professionals September 22nd-24th, 2010 in Los Angeles.

“This year’s conference agenda is called Progress in Motion and we have created a whole new agenda and brought in new speakers to focus on how far the industry is advanced over the last three years,” said Jonathan Edelheit, CEO of the Medical Tourism Association. “The new agenda, schedule format and new speakers will bring an exciting new dynamic to all the attendees,” he added.

The conference is the dedicated annual event of the Medical Tourism Association, the non profit trade association in the Medical Tourism industry,, and media partnerMedical Tourism Magazine, the only dedicated magazine for the medical tourism and global healthcare industry, and by Medical Tourism City,, a social network for the medical tourism and global healthcare industry with over one thousand participants from over sixty countries.

The 3rd World Medical Tourism and Global Healthcare Congress will also feature two additional conferences, the Expatriate Healthcare, Travel Insurance and Global Health Insurance Conference,, which focuses on international employers and insurance companies, and the Sustainable Healthcare and Hospital Development Conference,, which focuses on the growth of medical tourism in the healthcare sector and the building and development of healthcare facilities around the world.

The Medical Tourism Association™ (Global Healthcare Association) is the international non-profit trade association for the medical tourism and global healthcare industry made up of the top international hospitals, healthcare providers, medical travel facilitators, insurance companies, and other affiliated companies and members with the common goal of promoting the highest level of quality of healthcare to patients in a global environment. Our Association (Global Healthcare Association) promotes the interests of its healthcare provider and medical tourism facilitator members. The Medical Tourism Association™ (Global Healthcare Association) has three tenets: Transparency in Quality and Pricing, Communication and Education.

Amelia Fernandez
[email protected]
US 561-792-6676

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Aetna/SRC gives guidance on it’s Expense Incurred Copay Plans

July 1st, 2010 No comments

PPACA’s “Grandfathering” and Annual Limit Provisions and SRC Group Limited Benefit Medical Plans

This document is a high-level summary and should not be relied upon for legal advice. The June 14, 2010 and June 22, 2010 interim regulations are subject to change by HHS when final regulations are issued.

A: Overview
As you may know, Aetna and SRC have been leading an effort to ask the Department of Health & Human Services (HHS) if limited benefit plans can be exempted from the annual benefit limit prohibition set forth in the Patient Protection and Affordable Care Act (PPACA) signed into law on March 23, 2010.

Regulations released on June 22, 2010 specifically acknowledge the concerns we raised, and authorize HHS to create a program under which we may obtain a waiver if we can demonstrate that the limits are necessary in order to prevent a significant loss of coverage or increase in premiums. We will know more about what is required once that waiver program is established. See Section D. for further discussion.

Since it is likely that the waivers will apply only to grandfathered plans, it is important to understand the criteria for retaining grandfathered plan status.

B: Plan Changes Which Jeopardize Grandfathered Status
Clarifying regulations regarding grandfathering were provided by HHS on June 14, 2010. Per these regulations, a plan sponsor’s plan will be considered grandfathered if the plan sponsor has not made any of the following changes after March 23, 2010. These rules apply separately to each benefit package offered by an employer:

1. Changed insurance companies or insurance policies;*
2. Cut benefits resulting in loss of coverage for a particular condition;
3. Reduced an employer’s contribution by more than 5%;
4. Increased a member’s coinsurance percentage;
5. Increased a member’s fixed-amount copayment or cost-sharing above a specified level based on medical inflation;
6. Increased deductibles above a specified level based on medical inflation;
7. Reclassified employees so that the reclassified employees are eligible for a different plan (even if it’s a grandfathered plan), without a bona fide employment reason;
8. Added an overall annual limit, or reducing an existing overall annual limit; or
9. Failed to maintain at least one covered individual (not necessarily the same individual).

If a plan sponsor has made any of these invalidating changes, the regulations allow a plan to undo those changes effective as of the next plan year on or after September 23, 2010. SRC will work with plan sponsors to identify and address any issues concerning the grandfathered status of their plans.

C: Plan Changes Which Will Not Jeopardize Grandfathered Status
The regulations also provide guidance on changes which are acceptable and will not affect a plan’s grandfathered status. If a plan sponsor has made any of the changes listed below to the plan after March 23, 2010, there will be no adverse impact to the plan’s grandfathered status:

1. Changed third-party administrators (without changing insurers);
2. Changed premiums;
3. Made changes to comply with state or federal law, including PPACA;
4. Agreed to binding renewals before March 23, 2010, effective on or after March 23, 2010;
5. Allowed new employees and their dependents to enroll; or
6. Allowed new dependents of current subscribers to enroll.

D: Annual Benefit Limit Regulations
Under PPACA, HHS is authorized to allow some annual limits on the dollar value of benefits for plan years that begin on or after September 23, 2010—even for grandfathered plans.* Regulations issued on June 22, 2010 describe how annual limits will be phased out over three years. For plan years beginning September 23

• 2010, annual limits on essential health benefits may not be less than $750,000.
• 2011, annual limits on essential health benefits may not be less than $1.25 million.
• 2012, annual limits on essential health benefits may not be less than $2 million.

Annual limits will be eliminated altogether in January 2014.

HHS may create a program under which plans may obtain waivers from the annual benefit limit provisions if they show that complying with them would result in a significance loss of coverage or increase in premiums. We do not yet know what standards will be required or whether waivers will be available to plans that are not grandfathered. We will offer input to HHS about the criteria for approving waivers so that the negative impact on limited benefit plans will be reduced.

E: Summary
If HHS grants waivers from the annual benefit limit provisions for grandfathered limited benefit medical plans, and a plan sponsor’s group plan meets the conditions set forth in B above to be considered grandfathered, then our interpretation is that plan sponsors will be allowed to continue their plans at least until 2014.

Further, if a plan meets the grandfathered criteria listed above, plan sponsors will not be subject to other provisions of PPACA, such as:

• Coverage of preventive services with no cost sharing;
• Comprehensive coverage of “essential health benefits” (TBD); and
• Premium rates varying only by individual vs. family coverage, rating area, actuarial value, age, and tobacco use.

If you have questions, please contact your SRC Account Manager.

* Other key provisions of PPACA that apply to grandfathered group plans are:

• No lifetime limits;
• Extension of coverage to dependents until age 26;
• No pre-existing condition limitations for children under 19;
• Minimum Medical Loss Ratio requirements (beginning 2011; details TBD); and
• Required disclosure in member materials about the plan’s grandfathered status.

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