SMU health benefits will evolve over the next decade under the Patient Protection and Affordable Care Act (PPACA), according to a letter from SMU Human Resources sent by e-mail Aug. 26.

“The SMU Department of Human Resources is taking a close look at the requirements of the PPACA and how it will impact the benefits we offer, in 2011 and beyond,” the letter reads in part. “For the past several years, SMU has had to make some tough decisions around how to manage annual, double-digit increases in our medical expenses. Health care reform will add to our cost challenges, as we begin making the legally-required changes.

“The PPACA does not directly address the major cause of increased expenses: disease. That’s why we will continue to focus on prevention and disease management, and provide resources to help you understand your health status and address any risk factors you may have.”

Some changes will take effect in January 2011, including:

  • Removal of lifetime medical benefit maximums
  • Removal of annual limits for “select services” under medical plans
  • Removal of annual limits on medical plan preventive care benefits
  • Removal of pre-existing condition exclusions for children under age 19
  • Extended medical coverage for children (regardless of student or marital status) until age 26, unless coverage is available under another plan
  • Certain over-the-counter (OTC) medications no longer qualify as an eligible expense for reimbursement under a Flexible Spending Account (FSA) or Health Spending Account (HSA), unless the expense is accompanied by a doctor’s prescription

> Read the full text of the letter at the SMU Human Resources website