Section 1557 of the Affordable Care Act
Under Section 1557 of the Affordable Care Act (ACA), individuals may not be denied, cancelled, limited or refused health coverage on the basis of race, color, national origin, sex, age or disability. In May 2016, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) published a final rule on nondiscrimination in health programs and activities.
Effective July 18, 2016, the final rule is broad in scope. These nondiscrimination requirements impact insurers, sponsors of group health plans, health care professionals, and any entity receiving any type of financial assistance from the Department of Health and Human Services (HHS). Group health plans that needed to make benefits design changes – to be compliant – were required to make their benefits changes on the first day of the plan or policy year beginning on or after January 1, 2017.
Generally, the key requirements affecting health plans and services include:
- Expanded protection for transgender individuals
- Publicized “taglines” offering language assistance for people with limited English
- Prevalent “notices” offering communication assistance for individuals with disabilities
- Accessible grievance procedures for individuals who believe they have been subjected to discrimination in their health care or health care coverage
View the HHS sample notice
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EMPLOYER MANDATE IN REFORM
Businesses must offer affordable medical insurance that provides “minimum value” to employees and their dependents.
Public Marketplaces/ Exchanges
Marketplaces are the government run online shopping hubs for health insurance, available in every state.
INDIVIDUAL MANDATE IN REFORM
Under the health care reform law, all people must have minimum essential coverage beginning January 1, 2014.
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