ACA-compliant coverage

What is ACA-compliant coverage?

ACA-compliant coverage refers to a major medical health insurance policy that conforms to the regulations set forth in the Affordable Care Act (Obamacare).  These plans can be sold on or off the exchange, but all new employer-sponsored and individual major medical policies effective January 2014 or later are required to be ACA-compliant.

ACA-compliance is a little different for large group employer-sponsored plans as opposed to individual and small group plans (in most states, “large group” means 51+ employees). Individual and small group plans are required to include coverage for the ten essential benefits with no lifetime or annual benefit maximums, and must adhere to the consumer protections built into the law. Other than preventive care, large group plans are not required to cover the essential health benefits, although most of them do voluntarily. But large group plans are required to adhere to most of the rest of the ACA’s consumer protections.

Read more about ACA-compliant plans.

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