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New HHS Rules Cover College Health Plans

By CQ Staff

February 10, 2011 -- Students who are insured through their college or university would be covered under the health care overhaul law under a proposed regulation issued by the Department of Health and Human Services.

Currently, many university-based plans don't offer the same benefits as commercial insurance plans or that are called for under the health law. Their lifetime caps are often lower and benefits limited.

The proposed rules include such features as:

  • Insurers would no longer be able to impose lifetime dollar limits on the amount they spend on health benefits in student plans.
  • Insurers could not drop a sick student from a college plan if the student made an "unintentional mistake on an application."
  • Insurers could not deny or exclude coverage for students under age 19 because they have a preexisting condition.

The rule would allow some differences in student plans from other commercial health plans. For example, student health insurance plans would be able to have annual dollar limits on essential health benefits of no less than $100,000 for policies in effect before Sept. 23, 2012. After that date, student policies must conform to the rules in the health care law (PL 111-148, PL 111-152).

The new rules would also provide more transparency in the student health center marketplace, HHS officials said. Insurers would have to tell students enrolled in such plans whether they meet the requirements of the health care law.

HHS is asking for comments on the law and specially wants input on how other health care law protections should apply to student plans, including the choice of medical provider and how the new medical loss ratio rules should apply.

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