We have already covered that young adults can remain on the parent’s health plan longer, and that preventive care and women’s health services do not have copays, coinsurance or deductibles, and that children with pre-existing conditions can’t be denied coverage. But there is more.
Health plans can't cancel coverage if you get sick. They can only cancel coverage for nonpayment of premiums or if someone committed fraud when they applied for health insurance.
All health plans must also use the same standard form to help you compare plans. The Summary of Benefits and Coverage or SBC is a short, plain-language overview of what is covered, along with copays, coinsurance and deductibles. The SBC also includes coverage examples that allow you to see how much a member would typically pay in two common medical situations: Type 2 diabetes care and childbirth. SBC Example
In addition, health insurance companies are now expected to spend at least 80 percent of premiums on medical claims and activities that improve the quality of care for members in individual and small group plans (85 percent for large group plans). If an insurance company does not meet these targets, members or employer groups will receive the difference in the form of rebates or reduced premiums.
