The Affordable Care Act (ACA) is the landmark health reform legislation passed by Congress and signed into law by the President in March 2010.
The legislation includes a long list of health-related provisions that are intended to extend coverage to millions of Americans and implement measures that will lower health care costs and improve system efficiency.
Louisiana has a new health plan.Louisiana Health Cooperative (LAHC) is a non-profit, member-governed health insurance company that offers affordable health coverage options for individuals & small employers.
Introducing Louisiana Health Cooperative: LAHC is sponsored by a coalition of health care providers and business leaders, who believe that providing better access to high quality care at an affordable price will improve patients' outcomes.
Important Dates:Sept. 28, 2012 - U.S. Department of Health and Human Services (HHS) selects LAHC to create and operate a Consumer Oriented and Operated Plan, or "CO-OP" statewide
May 8, 2013 - Louisiana Department of Insurance grants LAHC a license to operate as an insurer statewide
October 1, 2013 - Open enrollment began
January 1, 2014 - Coverage begins for members enrolled in a health insurance plan
March 31, 2014 - Open enrollment ends
What are health CO-OPs?CO-OPs, like LAHC , are non-profit, member-governed health insurance companies with a focus on developing programs intended to improve the quality of health care delivered to members, such as:
- preventive programs offered with early health screenings;
- focusing on health outcomes based on sound clinical evidence;
- ongoing measurement and comparison of performance to clinical quality standards;
- a comprehensive medical network;
- coordinated care programs;
- opportunities for members to participate in their care.
LAHC's mission is to promote community health and well-being by engaging the members and providers it serves in the valued delivery of high quality, integrated health care services.
Will my doctor and community hospital participate in LAHC's network?LAHC has contracted physicians and hospitals in markets throughout Louisiana to serve as participating providers for the health plan. LAHC partners with providers that share in its mission of promoting community health and well-being and providing high-quality health care services.
View LAHC Statement on POS & HMO Provider Networks.
View Provider Directory for POS and HMO plans.
Marketplace Plans will not deny coverage based on pre-existing conditions.
Plans should include affordable basic benefit package that includes prevention and protection against catastrophic costs.
Plans offer "guaranteed issue"- insurers will not be permitted to refuse to insure any eligible individuals.
Plans will be offered in four comparable tiers with limited out of pocket expenses.
Plans have strict regulations on rescission or the retroactive cancellation of a health insurance policy.
Plans eliminate lifetime and annual limits.
What is the health insurance "Marketplace"?LAHC participates in the Federal Health Insurance Marketplace. Authorized by the Affordable Care Act, the Marketplace is where individuals can shop for and purchase health insurance online. The Marketplace allows consumers to compare benefits and costs of different plans, making insurance markets more transparent and facilitating consumer choice.
What are the essential health benefits available through the Marketplace?In February 2013, the Department of Health and Human Services ruled that individual and small group insurers participating in the Marketplace must cover the following essential health benefits beginning in January 2014:
- ambulatory patient services;
- emergency care;
- maternity & newborn care;
- mental health & substance use disorder services, including behavioral health treatment;
- prescription drugs;
- rehabilitative & rehabilitative services and devices;
- laboratory services;
- preventive and wellness services;
- chronic disease management; and
- pediatric services, including dental & vision care.
and moderate income individuals can receive premium and cost-sharing
subsidies to help offset monthly premiums that will only be available
through the Marketplace. The Marketplace will help determine eligibility
Under federal law, all Marketplaces must be fully certified and operational by January 1, 2014.
Go to the Federal Health Insurance Marketplace