The ACA requires most health insurance plans to cover a range of preventive services without cost-sharing, including vaccinations, screenings, and wellness visits, in 2010 and subsequent years (ongoing). These preventive services are graded ‘A’ or ‘B’ recommendations from the United States Preventive Services Task Force (USPSTF). For example, screening for depression is now recommended under this mandate. Note: the exact impact on specific supplemental health insurance plans can vary based on how they are structured and integrated with primary plans. It will depend on the precise interpretation of the rules and how this relates to a secondary coverage policy vs a primary one. Hence the impact can be deemed to be 'limited'. However, employers must be aware of the requirements of this ACA provision when designing supplemental plans to ensure compliance, even if the direct legal obligations fall on the primary plan sponsor, and not ArmadaCare. ArmadaCare will have to ensure they are compatible with this policy in 2010 (ongoing). There may also be a knock-on effect in the market that clients may want to ensure that they are adhering to best practices on these recommendations, and may ask ArmadaCare to follow them as well (even if not strictly enforced by law, as the primary responsibility is with the primary insurance provider). This may drive ArmadaCare to revisit its coverage model and update the portfolio of supplemental products offered as well. It could affect marketing and sales efforts as well in the future, to be more customer centric, not just liability centric. However, I have included it, as it has an ongoing influence on the healthcare market in the US (which is the target market).

This rule requires health insurers and group health plans to disclose pricing information for covered items and services, including negotiated rates and out-of-pocket costs, aiming to empower consumers to make informed healthcare decisions, effective in 2022 (with phased implementation). This provision in particular ensures transparency, as it allows potential clients and consumers to check prices with more ease. This leads to increased competition, more focus on transparency, customer satisfaction, and the value proposition. In particular, the supplemental plan offerings need to be differentiated, easy to use, and seamless to use. Any friction in the plan can lead to loss of business and the opposite if it easy and pain free. There may also be pressure on the cost structures and premiums offered, for smaller players like ArmadaCare vs the giants in the industry like UHC and Aetna.

MHPAEA requires health insurers and group health plans to provide mental health and substance use disorder benefits that are no more restrictive than medical/surgical benefits, in terms of cost-sharing, treatment limitations, and access to care, originally enacted in 2008 and expanded in subsequent years. This directly relates to WellPak, the mental health support program, and ComplaMed, the backfilling primary healthcare gaps (including mental health). This will mean that ArmadaCare will need to have parity on all of its mental health and substance use disorder benefits (if offered as part of the program). Parity means that the coverage and access to care is as good as that offered for medical / surgical benefits in the same health plan. This will mean that ArmadaCare will have to ensure that their internal policies and procedures around claims processing, benefit design, and network adequacy requirements for mental health benefits are non-discriminatory, and that it follows the parity rules.