Healthcare Reform

Information For Members

At SummaCare, our goal is to keep our members informed on any laws and mandates under the Affordable Care Act (ACA) that may affect you and/or your coverage.

SummaCare has already implemented numerous provisions of the ACA, including:

  • Coverage of adult dependents up to age 26 (under federal and state law). 
  • Coverage of certain preventive services at 100 percent including mammograms, immunizations and well-child care visits
  • Coverage of additional women’s preventive services at 100 percent (effective for new and/or renewing members as of August 1, 2012)
  • Elimination of lifetime limits of coverage
  • Regulation of annual limits of coverage
  • Distribution of Summary Benefits of Coverage documents (SBCs)
  • Effective January 1, 2014, all individuals qualify for health insurance coverage regardless of pre-existing health conditions and/or prescription use. Referred to as "guaranteed issue" in the ACA, health plans must permit individuals to enroll in a plan regardless of health status, age, gender or other factors that might predict the use of health services.
  • Also effective January 1, 2014, all individuals are required to have health insurance or pay a tax penalty. 

Please check www.healthcare.gov for updates and news regarding ACA mandates that may impact how you shop for and purchase health insurance coverage. 

The information contained in this section is provided for informational purposes only. If you have coverage through your employer, you employer will make you aware of any changes to your benefits during your next enrollment period.

Learn more about health insurance by watching Health Insurance Explained: The YouToons Have it Covered, written and produced by the Kaiser Family Foundation.