PPACA
Healthcare Reform Timeline
Courtesy of:
6500 City West Parkway
Suite 100
Eden Prairie, MN 55344
(952) 944-2929
www.horizonagency.com
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Minimum Loss Ratios
Coverage Appeals Process
Expansion of Non Discrimination Rules
Annual Benefit Limits
Lifetime Benefit Limits
Increased Dependent Coverage
Coverage of Emergency Services
Coverage of Preventive Care
Designating a Primary Care Physician
Rebates for Medicare Part D “Donut Hole”
Reporting on W-2s
Long Term Care Program
Health FSA, HRA, HSA Reimbursements
HSA and Archer MSA Distribution Increases
Federal Study on Self-Insured Plans
Tax to Fund Comparative Effectiveness Research
New Plan Disclosure Requirement
Material Modification of Plan Provision
FSA Limit
Medicare Payroll Tax Increase
Medical Expense Deduction
New Employer Discloser Obligation Regarding Exchanges
New Reporting Obligation Regarding Employers Furnishing
Quality and Affordable Coverage
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New Obligation Regarding Employee’s “Minimum Essential
Coverage”
Employee Waiting Period for Coverage
Free Choice Vouchers
Employer Penalty for Offering Coverage that’s not
“Qualifying” and “Affordable”
Determination and Potential Application of Employer
Penalty for Categories of Employees
Pre-Existing Conditions
Wellness Program
Coverage for Clinical Trials
Annual Benefit Limits
Modified Community Rating Requirements
State Based Exchanges
Excise Tax on High Value Health Plans “Cadillac Plans”
Auto Enrollment by Employers
Individual Mandate
Helping Employees Prepare for Health Care
Reform Legislation (Individual Refusal to Purchase Coverage)
Health Care Reform – Estimated Financial Impact
For Employers
Health Care Reform “Grandfathered” Provision
Preventive Care Services
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Page 21
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Page 23 - 26
Page 27 - 29
Health Care Reform
Effective Dates
TOPIC
Effective Date
of the Change
Description of the Change
Minimum loss ratio requirements will be established
for insurers in all markets (self-insured plans are
exempt).
The Minimum Loss Ratio is:
Regulatory process
with DHHS and NAIC
begins in 2010.
Minimum Loss
Ratios (MLR)
The standards and
any potential
rebates to
policyholders being
applied to the 2011
plan.
o
85% for large group plans (101 employees
or more)
o
80% for small group plans (100 and
below)
o
80% for individual plans
The calculation is independent of:
o
Federal taxes
o
State taxes
o
Any payments as a result of the risk
adjustment provisions
o
Any payments as a result of the
reinsurance provisions
Carriers will have to issue a premium rebate to
individuals for plans that fail to meet the Minimum
Loss Ratio requirements.
Allows the Secretary of DHHS to make adjustments
to the percentage if it proves to be destabilizing to
the individual or small group markets.
The National Association of Insurance
Commissioners (NAIC) is required to establish
uniform definitions regarding the Minimum Loss
Ratio and how the rebate is calculated by
December 31, 2010.
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4
Health Care Reform
Effective Dates
TOPIC
Effective
Date of the
Change
Description of the Change
Requires plans to have an internal and external
coverage appeals process for:
•
Fully-insured individual health plans
•
Fully-insured group plans
•
Self-insured group health plans
At a minimum, plans and issuers must:
Coverage Appeals
Process
Expansion of Non
Discrimination
Rules for Fully
Insured Groups
5
Plan years
beginning on
or after
September 23,
2010
Plan years
beginning on
or after
September 23,
2010
•
have an internal claims process in effect,
which process must initially incorporate the
current claims procedure regulations issued
by the Department of Labor in 2001
•
provide notice to enrollees, in a culturally
and linguistically appropriate manner, of
available internal and external appeals
processes, and the availability of any
applicable office of health insurance
consumer assistance or ombudsman to assist
them with the appeals processes
•
allow enrollees to review their files, to
present evidence and testimony as part of
the appeals process, and to receive
continued coverage pending the outcome of
the appeals process
•
implement an external review process that
meets applicable state requirements and
guidance that is to be issued by HHS
Discrimination testing applies to fully insured groups. The
plan administrator will be subject to penalties if the plan
fails to comply with the nondiscrimination rules. However
highly compensated employees will not be taxed on excess
reimbursements. The employer will be subject to a $100
per day/per affected participant excise tax for a failure to
satisfy the nondiscrimination requirement.
Copyright © Innovative Benefit Planning LLC 2010. All Rights Reserved.
Health Care Reform
Effective Dates
TOPIC
Effective Date
of the Change
Description of the Change
Annual Benefit
Limit
(All Plans)
Plan years
beginning on
or after
September 23, 2010
Would be limited to DHHS-defined “non-essential”
benefits for plans years beginning prior to January
1, 2014. Annual limits would be prohibited entirely
for plan years beginning on or after January 1,
2014.
Lifetime
Benefit Limits
(All Plans)
Plan years
beginning on
or after
September 23, 2010
Prohibits lifetime limits on the dollar value of
benefits for any participant or beneficiary
Increased
Dependent
Coverage
(All Plans)
Plan years
beginning on
or after
September 23, 2010
Increases the age of dependents for health plan
coverage to age 26 (including married and/or nonstudent dependents)
Coverage of
Emergency
Services (NonGrandfathered
Plans)
Plan years
beginning on
or after
September 23, 2010
Emergency Services paid at in-network level,
regardless of provider
Coverage of
Preventive
Care (NonGrandfathered
Plans)
Plan years
beginning on
or after
September 23, 2010
Plans must not impose cost sharing on defined
preventive care services. Services are yet to be
defined
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6
Health Care Reform
Effective Dates
TOPIC
Effective Date
of the Change
Designating a
Primary Care
Physician
Plan years
beginning on
or after
September 23,
2010
Rebates for
Medicare
Part D "Donut
Hole"
January 1, 2010 for
rebate.
Other measures
noted
begin January 1,
2011.
Description of the Change
Allows enrollees to designate an allopathic or
osteopathic in-network doctor as their primary
care physician (if plan requires a designation)
There is a gap in Medicare prescription drug
coverage (Medicare Part D) between $2,830 and
$6,440 in total drug spending. The health care
reform bill provides a $250 rebate check for all
Medicare Part D enrollees who enter this “donut
hole.”
Beginning in 2011, a 50 percent discount on brandname drugs will be instituted and generic drug
coverage will be provided in the donut hole. The
donut hole gap will be filled by 2020.
Beginning in 2011, the beneficiary co-insurance
rate in the Medicare Part D coverage gap will
gradually reduce from the current 100% to 25% in
2020 with 75% discounts on brand and generic
drugs.
7
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Health Care Reform
Effective Dates
TOPIC
Reporting on
W-2’s
Long Term Care
Program
Effective Date
of the Change
January
1st,
2011
January 1st, 2011
Description of the Change
Requires all employers to include on W-2’s the
aggregate cost of employer – sponsored health
plans
Employers must enroll employees in new
voluntary public long-term care program, unless
employee opts out; requires employer to payroll
deduct premiums
Health FSA,
HRA, HSA
Reimbursements
January
HSA and Archer
MSA Distribution
Tax Increases
January 1st, 2011
Increases the tax on nonqualified distributions
from HSA’s and Archer MSA’s from 10% to 20%
March 2011
Federal Dept of Labor begins mandated studies on
self-insured plans using data collected from
Annual Form 5500
Federal Study on
Self-Insured
Plans
1st,
2011
May no longer be reimbursed for (OTC) meds
unless prescribed by a doctor.
Insulin RX is an exception
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8
Health Care Reform
Effective Dates
TOPIC
Effective Date
of the Change
Description of the Change
Tax to Fund
Comparative
Effectiveness
Research
2012
New Federal tax on fully insured and selffunded group plans equal to $2 per enrollee
March, 2012
All plan sponsors must supply applicants and
participants at enrollment and re-enrollment, a
new form of plan summary that cannot exceed
4 pages but must include information on
benefits, exclusions, cost sharing requirements,
and other information. Federal authorities will
provide a standard template.
Penalty for noncompliance: $1,000 per failure
March, 2012
Notice of material changes must be provided to
enrollees not later than 60 days prior to the
date on which such modification will be come
effective.
January 1st, 2013
Limits Flexible Healthcare Spending
contributions to $2,500 per year and indexes
the cap for inflation
New Plan
Disclosure
Requirement;
(Benefit
Summaries)
Material
Modification
of Plan
Provision
FSA Limit
9
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Health Care Reform
Effective Dates
TOPIC
Medicare
Payroll Tax
Increase
Medical Expense
Deduction
New Employer
Discloser
Obligation
Regarding
Exchanges
Effective Date
of the Change
Description of the Change
January 1st, 2013
An additional 0.9% Medicare Hospital
Insurance Tax on employees with respect to
earning and wages received during the year
above $200,000 for individuals and $250,000
for joint filers (from 1.45% to 2.35% on
amounts in excess of threshold)
January 1st, 2013
Threshold to itemize deduction of medical
expenses will increase to 10% of Adjusted
Gross Income (up from 7.5%) Will not apply
to individuals 65 or older form 2013 to 2016
March 1st, 2013
Employers must supply employees with
written notice regarding the existence of
the Insurance Exchange(s), the services
supplied the Exchange, how the employee
may contact the Exchange, and if the
employer is not supplying qualifying
coverage that the employee might qualify
for subsidies in the exchange, for the
purchase of insurance
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10
Health Care Reform
Effective Dates
TOPIC
New Reporting
Obligation
Regarding
Employer’s
Furnishing of
Qualifying and
Affordable
Coverage
Effective Date
of the Change
January 1st, 2014
Description of the Change
Employers to annually report to government
and to covered employees, by January 31, the
details of the employer’s coverage, eligibility,
premium requirements, employer contribution
and health plan enrollees, to allow government
to determine if surcharge applies.
Penalty: $50 for each missed statement to an
employee, to max of $100,000
New Reporting
Obligation
Regarding
Employee’s
“Minimum
Essential
Coverage”
January 1st, 2014
Employers to provide an annual statement to
the government and covered individuals,
reflecting the months during the calendar year
for which the individual had “minimum
essential coverage” so as to avoid the individual
mandate penalty for those months. Penalty:
$50 for each missed statement to an employee,
to max of $100,000
Employee Waiting
Period for
Coverage
(All Plans)
January 1st, 2014
Employer’s waiting period for coverage may not
be in excess of 90 days
11
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Health Care Reform
Effective Dates
TOPIC
Free
Choice
Vouchers
Effective Date
of the Change
Description of the Change
January 1st, 2014
Employers offering coverage are required to provide
“free choice vouchers” to qualified employees to
purchase insurance through the exchanges. To be
eligible for the voucher the employer’s plan would cost
the employee between 8% and 9.8% of employee’s
household income, and the employee’s household
income would be at or below 400% of the Federal Poverty
Level. Employer pays cost of voucher; voucher equals
100% of maximum contribution the employer would have
provided if the employee were enrolled in the group
plan.
% of FPL
Single
Income
8.0%
(Monthly)
9.8%
(Monthly)
Family of
4 Income
8.0%
(Monthly)
9.8%
(Monthly)
100%
$10,830
$72.20
$88.45
$22,050
$147.00
$180.07
150%
$16,245
$108.30
$132.67
$33,075
$220.50
$270.11
200%
$21,660
$144.40
$176.89
$44,100
$294.00
$360.15
250%
$27,075
$180.50
$211.11
$55,125
$367.50
$450.19
300%
$32,490
$216.60
$265.34
$66,150
$441.00
$540.23
400%
$43,320
$288.80
$353.78
$88,200
$588.00
$720.29
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12
Health Care Reform
Effective Dates
TOPIC
Employer
Penalty for
Offering
Coverage
that’s not
“Qualifying”
and
“Affordable”
Effective Date
of the Change
Description of the Change
January 1st, 2014
Penalties assessed if employer coverage is
considered “unaffordable”; employee
contributions to the plan must not exceed 9.5% of
employee’s household income or if the plan is not
“qualifying” – has an actuarial value of less than
60% of covered health care expenses. Penalty:
$3,000 per full time employee who receives a
subsidy through an insurance Exchange; capped at
$2,000 X total # of FTEs with 1st 30 FTEs excluded.
Maximum
Single
Premium
Family of 4
Income
Maximum
Family of 4
Premium
% of FPL
Max. %
Single
Income
133%
3.00%
$14,404
$36.01
$29,327
$73.32
150%
4.00%
$16,245
$54.15
$33,075
$110.25
200%
6.30%
$21,660
$113.72
$44,100
$231.53
250%
8.05%
$27,075
$181.63
$55,125
$369.80
300%
9.50%
$32,490
$257.21
$66,150
$523.69
400%
9.50%
$43,320
$342.95
$88,200
$698.25
13
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Determination and Potential
Application of Employer Penalty for
Categories of Employees
Employee
Category
How is this category
of employee used to
determine “large
employer”
Once an employer is
deemed to be a “larger
employer” could the
employer be subject to a
penalty if this type of
employee received a
premium credit?
Full-time
Counted as one employee,
based on a 30 hour or more
work week
Yes
Part-time
Prorated (calculated by
taking the hours worked by
part-time employees in a
month divided by 120)
No
Seasonal
Not counted, for those
working less than 120 days in
a year
Yes, for the month in which a
seasonal workers is full-time
Temporary
Agency
Generally, counted as
working for the temporary
agency (except for those
workers who are independent
contractors)
Yes, for those counted as working for
the temporary agency
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14
Health Care Reform
Effective Dates
TOPIC
Preexisting
Condition
Wellness
Programs
Coverage for
Clinical Trials
Annual Benefit
Limits
(All Plans)
15
Effective
Date of the
Change
Description of the Change
2014
Preexisting condition exclusions eliminated for all
participants; coverage must guarantee issue and
guarantee renewable
January 1st, 2014
Employers can offer increased incentives or
rewards to employees for participation in a
wellness program or for meeting certain health
status targets. Reward or premium reductions of
to 30% of the cost of coverage are permissible.
(Regulations could increase to 50%)
January
January
1st,
1st,
2014
January 1st, 2014
Plans must provide coverage for participation in
clinical trials for treatment of cancer or other lifethreatening diseases
Annual limits on benefit coverage no longer
permitted
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Health Care Reform
Effective Dates
TOPIC
Effective Date
of the Change
Description of the Change
Strict modified community rating standards must be
adhered to by:
Modified
CommunityRating
Requirements
•
All individual health insurance policies
•
All fully insured group policies of 100 lives
and under
•
Larger groups purchasing coverage
through the exchanges
Premium variations would only be allowed for:
January 1st, 2014
•
Age (3:1)
•
Tobacco use (1.5:1)
•
Family composition
•
Geographic regions to be defined by the
states
Experience rating would be prohibited.
Wellness discounts are allowed for group plans under
specific circumstances.
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16
Health Care Reform
Effective Dates
TOPIC
Effective Date
of the Change
Description of the Change
Requires each state to create an Exchange to facilitate
the sale of qualified benefit plans to individuals,
including:
•
The federally-administered multi-state plans
•
Non-profit co-operative plans.
Levels of coverage to be offered through the Exchange:
•
Bronze Plan - provides 60% of actuarial
value of minimum qualifying coverage
StateBased
Exchanges
January
1st,
2014
•
Silver Plan - provides 70% of actuarial value
of minimum qualifying coverage
•
Gold Plan - provides 80% of actuarial value
of minimum qualifying coverage
•
Platinum Plan - provides 90% of actuarial
value of minimum qualifying coverage
•
A catastrophic-only policy would be
available for those 30 and younger.
"Actuarial value" - the anticipated amount of all
eligible expenses (including deductibles, co-pays, etc.)
that will be paid by the plan.
Deductible limits of $2,000 individual and $4,000
family, unless contributions are offered that offset
excess deductibles.
17
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Health Care Reform
Effective Dates
TOPIC
Effective Date
of the Change
Description of the Change
Out-of-Pocket limits for all Exchange plans must be
no more than OOP limits for HSA-compatible HDHPs
($5,950 single; $11,900 family)
The states must create “SHOP Exchanges” to help
small employers purchase such coverage.
The states can establish regional Exchanges.
StateBased
Exchanges
The state can either:
• Create one exchange to serve both the
individual and group market
• Create a separate individual market
exchange and group SHOP exchange.
January 1st, 2014
States can also apply for a modification waiver from
DHHS.
U. S. territories would:
• Be allowed to create Exchanges
• Be treated like a state for funding
purposes, if they establish an Exchange
Exchanges must:
• Maintain a call center
• Provide consumer information (including
open enrollment)
• Maintain a website
• Submit financial reports
• Comply with oversight investigations
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18
Health Care Reform
Effective Dates
TOPIC
Excise Tax on
High Value
Health Plans
“Cadillac
Plans”
AutoEnrollment by
Employers
(All Plans)
19
Effective Date
of the Change
Description of the Change
January 1st 2018
Employers offering health plans that exceed a
certain cost (the total employee and employer
cost) would be subject to 40% excise tax on
amount above that value. For individual
coverage, the threshold would be $10,200; for
family coverage the threshold would be $27,500.
These thresholds would be indexed at CPI plus
one percentage point. Certain high-risk
professions would have higher cost thresholds.
(Calculation includes value of Medical, Dental,
Vision…, Reimbursement from HRA and FSA, and
Employer contributions to H.S.A)
January 1, 2014
(After issuance of
regulations)
Requires employers with 200 or more employees
to auto-enroll all new employees into any
available employer-sponsored health insurance
plan. Employees may opt out if they have
another source of coverage
Copyright © Innovative Benefit Planning LLC 2010. All Rights Reserved.
Helping Employees Prepare for Health Care Reform
Legislation (Individual Refusal to Purchase Coverage)
TOPIC
Individual
Mandate
Effective Date
of the Change
Description of the Change
January 1, 2014.
Requires all American citizens and legal residents to
purchase qualified health insurance.
Coverage considered qualifying for this purpose
includes:
–Qualified Exchange plans
–Grandfathered individual and group health
plans
–Medicare and Medicaid plans
–Military and veterans' benefits
–Any employer-sponsored plan
Existing policies could remain in effect - but only so
long as an individual does not:
–Move
–Change jobs
–Experience any other material change in life
status
Violators are subject to an excise tax penalty.
20
Helping Employees Prepare for Health Care Reform
Legislation (Individual Refusal to Purchase Coverage)
Penalty Table
Household Income
2014 Penalty
2015 Penalty
2016 Penalty
$10,830
$108.30
$325.00
$695.00
$21,660
$216.60
$433.20
$695.00
$32,490
$324.90
$694.80
$812.25
$43,320
$433.20
$866.40
$1,083.00
$55,125
$551.25
$1,102.50
$1,378.13
$66,150
$661.50
$1,323.00
$1,653.75
$77,175
$771.75
$1,543.50
$1,929.38
$88,200
$882.00
$1,764.00
$2,205.00
21
Health Care Reform – Estimated
Financial Impact for Employers
Item
Expected Medical
Cost Impact*
SHORT-TERM:
No cost-sharing on preventative care:
If preventative care is not currently covered**
3% - 4%
Remove existing cost-sharing from preventative care**
1% - 2%
Dependent age increase to 26 (Post-9/2010)
1.5% - 2%
Remove Lifetime maximum
Federal Tax to fund research
0.1% - 0.5%
$2 per enrollee per year
Remove pre-existing for enrollees under 19
Immaterial
LONG-TERM:
Cost shift due to public programs
TBD
Tax assessments and fees
TBD
Compliance/administrative impact
TBD
*These are the impacts for typical cases. The impact for any specific case may vary from these
amounts.
**Not required of Grandfathered Plans.
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22
Health Care Reform
“Grandfathered” Provision
Grandfathered
Non
Grandfathered
Dependents to age 26
X
X
Unlimited Lifetime Maximums
X
X
No Annual $ Limits
X
X
No Pre-Existing Conditions for Dependents
X
X
Reform Provision
100% Preventive Care
X
Emergency Care at In-Network Level
X
Pediatrician as Primary Care Physician
X
No Referral to OB/GYN
X
Non-Discrimination applies to fully insured
group
X
Must Cover Essential Benefits 2014
X
Medical Loss Ratio
23
X
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X
Healthcare Reform
“Grandfathered” Provision
General Requirements
Regulations also condition grandfathered status on the sponsor
taking the following affirmative steps:
• Including “in any plan materials provided to a participant or
beneficiary that describes the benefits provided under the
plan” (such as a summary plan description) a statement
that the plan believes it is a grandfathered health
plan within the meaning of Section 1251 of the Act. This
•
•
statement must also provide contact information for
questions and complaints. The regulations include model
language that may be used to satisfy this disclosure
requirement.
Maintaining records that document the terms of the plan as in
effect on March 23, 2010, along with any other documents
necessary to verify, explain, or clarify, the plan’s status as
grandfathered health plan. Those records must then be made
available for examination upon request by a participant,
beneficiary, or government agency.
In addition to being in effect on March 23, 2010, a
grandfathered plan must avoid taking any action that would
undermine its grandfathered status. The types of actions that
would cause a plan to lose its grandfathered status are
described in the next section.
Copyright © Innovative Benefit Planning LLC 2010. All Rights Reserved.
24
Healthcare Reform
“Grandfathered” Provision
Actions that would result in losing “Grandfathered” status:
1.
2.
3.
4.
Change in insurance carrier, policy, certificate or contract.
Elimination of all benefits to diagnose or treat a particular
condition.
Any increase in coinsurance.
An increase in deductibles or copayments subject to the
applicable cost-adjustment test established by the federal
government.
–
Compared with copayments in effect on March 23,
2010, grandfathered plans will be able to increase
those copayments by no more than the greater of
$5 (adjusted annually for medical inflation) or a
percentage equal to the medical inflation plus 15
percentage points.
–
25
Compared with the deductible required as of
March 23, 2010, grandfathered plans can only
increase these deductible by a percentage equal
to medical inflation plus 15 percentage points.
5.
Change in funding status from self-funded to fully
insured.
6.
A decrease in employer contribution of more than 5%.
Copyright © Innovative Benefit Planning LLC 2010. All Rights Reserved.
Healthcare Reform
“Grandfathered” Provision
Actions that would NOT result in losing “Grandfathered” status:
1.
2.
3.
4.
5.
6.
7.
8.
Changes to premium – as long as there isn’t more than a 5%
reduction in the percentage of the employer’s contribution.
Changes to increase benefits, or voluntarily comply with
provisions of federal and state law as long as changes
comply with the applicable grandfathering restrictions.
Changes to a provider network.
Changes to a prescription drug formulary unless the changes
act to eliminate a benefit.
Changes to accommodate mergers and acquisitions.
Changes to a plan’s third party administrators as long as the
benefits continue to satisfy grandfathering.
Changing funding status from fully insured to self-insured as
long as the benefits continue to satisfy grandfathering.
The regulations provide that the grandfathering rules apply
separately to each "benefit package" made available under
a health plan. Thus, a plan offering both an HMO and a PPO
option might choose to modify the PPO's deductible or
copayment in a way that would cause the PPO to lose its
grandfathered status, without thereby forfeiting the HMO's
grandfathered status.
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26
Preventive Care Services
The following is a checklist of procedures and services that are classified as
“preventive services” under PPACA. These services are to be covered without
copayment, coinsurance, and/or deductible when provided by an in-network
provider effective September 23, 2010 or first plan renewal there after.
Preventive
Men
Screening for abdominal
aortic aneurysm
Alcohol Misuse Screening and
Behavioral Counseling
Interventions and
Assessments
Aspirin for the Prevention of
Cardiovascular Disease
Asymptomatic Bacteriuria in
Adults, Screening
Breast Cancer, Screening
Breast and Ovarian Cancer
Susceptibility, Genetic Risk
Assessment and BRCA
Mutation Testing
Breastfeeding Primary Care
Interventions to Promote
Cervical Cancer, Screening
Chlamydia Infection,
Screening
Cholesterol Screening
Colorectal Cancer Screening
over age 50
Congenital Hypothyroidism,
Screening in Newborns
Dental Health Assessment &
Fluoride Supplements
Depression Screening &
Treatment
Diet, Behavioral Counseling in
Primary Care
27
Women
Pregnant
Women
Children
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Copyright © Innovative Benefit Planning LLC 2010. All Rights Reserved.
X
Preventive Care Services – con’t
Preventive Service
Gonorrhea, Screening
Gonorrhea, Prophylactic
Medication for Newborns
Hearing Loss in Newborns,
Screening
Hepatitis B Virus Infection,
Screening
High Blood Pressure, Screening
HIV, Screening
Iron Deficiency Anemia
Prevention, Screening &
Supplements
Iron Deficiency Anemia
Prevention, Screening &
Supplements
Physical Exam & Measurements
Obesity Screening & Counseling
Osteoporosis in Postmenopausal
Women, Screening over 60
Phenylketonuria (PKU), Screening
Rh (D) Incompatibility, Screening
Sexually Transmitted Infections
Prevention
Sickle Cell Disease, Newborns
Screening
Syphilis Infection, Screening
Tobacco Use and Tobacco-Caused
Disease, Counseling
Type 2 Diabetes Mellitus in Adults,
Screening
Visual Impairment in Children
Younger than Age 5 Years,
Screening
Men
Women
X
Pregnant
Women
X
Children
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Copyright © Innovative Benefit Planning LLC 2010. All Rights Reserved.
X
X
28
Preventive Care Services – con’t
Immunization Vaccines
Men
Women
Up to 18
Dose/Age Vary
Diphtheria, Tetanus, Pertussis
X
X
X
X
Haemophilus Influenzae Type B
Hepatitis A
X
X
X
Hepatitis B
X
X
X
Herpes Zoster
X
X
Human Papillomavirus
X
X
X
X
Inactivated Poliovirus
Influenza
X
X
X
Measles, Mumps, Rubella
X
X
X
Meningococcal
X
X
X
Pneumococcal
X
`X
X
X
Rotavirus
Varicella
29
X
X
Copyright © Innovative Benefit Planning LLC 2010. All Rights Reserved.
X
Copyright © Innovative Benefit Planning LLC 2010. All Rights Reserved.