WGAT Receives Waiver Under Health Care Reform Law

Western Growers Assurance Trust (WGAT) has been granted a one-year waiver from the U.S. Department of Health and Human Services (HHS) exempting it from the $750,000 annual limitation requirement in the new health care reform law. 

The waiver covers the one year period from July 1, 2011 to June 30, 2010 meaning that existing WGAT mini-med plans are approved for the next 19 months. WGAT will reapply next year for an additional one year waiver. All participants affected by the waiver will be notified by WGAT and the specific dollar amount of the annual limit and the benefits to which the limit applies will be provided.  

Under the health care reform law, employers/carriers must move toward coverage that sets no annual limits on essential benefits. In 2011, the annual limit on essential benefits is set at $750,000. In 2012, the floor is established at $1.25 million, 2013 at $2 million and by 2014, there cannot be annual limits on essential benefits coverage. However, employers/carriers may apply annually for waivers until 2014, if they can establish that their health plans were already in place prior to Sept. 23, 2010 and that individuals on the plan will experience either a substantial increase in premiums or decrease in access to benefits as a result of the mandated annual coverage requirements (e.g. employers dropping/canceling employee health plans). For more information, please contact Jasper Hempel at jhempel@wga.com or (949) 885-2340.