Health Insurance Regulations

May 19, 2020

The health insurance sector consists of three distinct segments — individual, small and large — all of which are regulated by separate economic and regulatory frameworks.

A variety of border-crossing strategies have evolved to reduce the pressures of one section and to draw on the advantages of another. Drawing on detailed systematic studies into the workings of current business systems, this article explains these strategies and their goals and consequences.

Medical Care is essential for any situation as a preventative measure to keep sickness and illness at bay. The Affordable Care Act (ACA) requires all people to have health care or to face a fine.

In the current law, however, businesses with less than 50 full-time equivalent staff are not required to offer benefits to their workers. When businesses do provide health care benefits, they will be subject to both state and federal laws.

Most Health insurance covers these huge costs and offers many important benefits.

  • Health insurance covers essential benefits critical to maintaining health and treating illness and minor or major accidents
  • Protects you from unexpected, and high medical costs
  • Free preventive care, like vaccines, screenings, and some check-ups

All plans cover and offer these 10 essential benefits:

  • Emergency & Ambulatory patient services
  • Hospitalization and minor or major surgeries
  • Pregnancy, maternity, and newborn care (before and after birth)
  • Counseling, psychotherapy, mental health and substance use disorders
  • Prescription drugs
  • Rehabilitative services and devices (Devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and/or physical skills)
  • Laboratory services (Blood and other fluid testing)
  • Wellness services and chronic disease management
  • Pediatric services
  • Some may include oral and vision care