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ND Blue Cross Blue Shield preps employers for new health care requirements

FARGO -- Many provisions of the Affordable Care Act have yet to take effect, more than three years after the health care reform legislation passed Congress and was signed into law.

But that will change soon, and Blue Cross Blue Shield of North Dakota officials said Thursday that the bulk of the remaining changes in the reform law often called Obamacare will become the law of the land Jan. 1.

The insurance company that covers more than 405,000 North Dakotans held two sessions Thursday at the Fargo Holiday Inn to field questions from employers on what they need to do to prepare for the changes, wrapping up the eighth city in the state that BCBS has held forums in over the past two weeks.

Luther Stueland, director of health policy impact and exchange operations, said similar forums last fall drew representatives from about 500 employers. The meetings this month were attended by about 1,500 employers - showing rising interest in what the new requirements will mean.

"We've sensed the demand and the desire for employers to know how is this going to impact me, so that's why we've made the effort to do these sessions," he said.

The Affordable Care Act was passed in March 2010, and the first changes were seen that year. Dependents gained the ability to stay on their parents' insurance plans until age 26, lifetime limits on coverage were scrapped and children no longer can be denied coverage because of preexisting conditions.

But many of the bill's reforms -- especially concerning employer requirements -- go into effect Jan. 1, according to Employer Consulting and Wellness Services Director Mike Potts.

Most Americans will be required to have health insurance or pay a penalty. All companies with 50 or more employees will need to either offer qualifying coverage to full-time workers or help pay for their costs through an insurance marketplace in each state that will start open enrollment Oct. 1 and provide coverage starting in 2014.

Jan. 1 also will mark the end of adults being denied coverage because of preexisting conditions and ban annual limits on coverage.

Stueland said the impact of the changes depends on how many employees a company has and if it offers a plan in place when the law was passed. Companies that offered insurance on March 23, 2010, can maintain those plans indefinitely as long as they don't reduce the value to employees.

Non-grandfathered plans will have to meet additional requirements for benefits and cost sharing.

Stueland said there's a better understanding of the specifics of the law now than shortly after its passage. Still, he said, what the reform will actually mean is yet to be determined.

"How it will play out and how some of those competing provisions actually affect the market is what is really still the remaining unknown," he said. "It's an enormously complex piece of legislation, and so it would be hard for anybody to definitively say, 'Here's what's going to happen.'"

Potts said Blue Cross will continue to provide as much information for employers and individuals as the next wave of changes approaches.