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As the owner of an independent health insurance agency and the founder of a website for comparing health insurance providers I often get asked, "What type of health insurance do YOU have?" Of course, no one health insurance company or health insurance plan is right for everyone because everyone has different needs, lives in a different area, etc… but I can certainly feel comfortable telling people that I personally have a Health Savings Account (HSA) and I absolutely love it!
Here are 7 reasons why I love my HSA:
#1 All Contributions to my HSA are Tax Deductible
Every single dollar that I contribute into my HSA http://www.easytoinsureme.com/united-health-one.html every year is deductible on the front of my personal 1040 tax return (up to certain annual limits imposed by the IRS – for 2010 the maximum deductible HSA contribution is $3,050 for singles and $6,150 for families with those age 55 or over getting an extra $1,000 allotted maximum contribution amount). This HSA contribution deduction is great because it is an "above the line" deduction meaning that it is deducted before arriving at your Adjusted Gross Income (AGI) number. To make this deduction even better there are absolutely no income phaseouts for the HSA contribution deduction so you could be Bill Gates or Warren Buffet and still take the full HSA contribution deduction. The more money you make the more attractive this deduction is to you.
#2 The Money in my HSA Grows Tax Free
All of the money in my Health Savings Account grows tax free as long as I use the money in the account for qualified medical expenses or wait until I am age 65 or older and use it for my retirement. Yes, you heard me right "Tax Free" not just "Tax Deferred" as you may be accustomed to hearing about with a 401K or other similar tax deferred account.
#3 I Can Choose any Health Insurance Company I Want
Another reason I love my HSA is that the HSA itself is simply a savings account with some special paperwork so that it receives special treatment from the IRS. The HSA itself is NOT health insurance but is simply the second component of what is commonly thought of as a HSA health insurance plan with the first component being a high deductible health insurance plan (according to the IRS a high deductible health insurance plan is any health plan with a deductible of at least $1,200 for singles and $2,400 for families – so still pretty low minimums). What this means is that many different banks offer Health Savings Accounts and you can choose the bank that you prefer to set up your HSA and then buy your high deductible health insurance plan from any insurance company that you like. You can even purchase a plan from United Healthcare one year and then shop around in year two and switch to a potentially cheaper plan with Humana and then in year three switch to Blue Cross Blue Shield, etc. This ability to constantly comparison shop and not be tied to one particular insurance provider is a great benefit to an HSA (as your actual savings account component of the plan still stays with your original bank).
The higher the deductible is on your health insurance plan then the lower your monthly premium payments will be. Since a high deductible health insurance plan is a requirement for opening a Health Savings Account then one of the nice things about the plans is that the monthly premiums are comparatively very low! I would much rather save a large sum of money every month by paying less in premiums each month than paying extra for a very low deductible and co-pays.
#5 I Am Firmly In Control of My Health Care Dollars
The beautiful thing about an Health Savings Account as compared to a Flexible Spending Account is that while Flex Spending Accounts require you to use up the money in the account every year all of the money that you contribute to an HSA rolls over from year to year. In fact, as mentioned above, even if you don't end up using the money in your HSA for medical expenses (a good thing!) then when you reach age 65 you can withdraw the money tax free for your retirement. Most HSA custodians will give you an option to place your HSA money into a savings account, investment account, etc. as the decision is up to you as to where you place your HSA account money.
#6 I Can Rest Easy
Admittedly some people simply sleep better at night knowing that they have a very low deductible and low co-pays for things like doctor's visits and prescriptions and I understand that but I like to think of it like this - After your first year of contributing the maximum to your HSA then unless you use up all of the money with a large unforeseen medical bill then you will have enough money in your HSA for years two and on that even if you have to meet your deductible then as long as your HSA health insurance plan covers all expenses 100% once the deductible is met then you effectively have zero out of pocket costs because you already have the money in your HSA account! Sure, if you start an HSA tomorrow and you have only contributed a couple hundred dollars into the account so far and you get hit with a big medical bill then you will have to come out of pocket for your deductible amount but once you have maxed out your HSA contribution for a year or two then you are essentially home free with potentially no additional out of pocket costs even for large medical bills!
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For many companies the ability to provide group health insurance to their employees is a huge benefit that hard workers will truly value especially if they have a family to take care of at home. However sometimes the task of setting up a group health insurance program can be difficult for many new and smaller companies. Fortunately a group health insurance broker can be readily and easily used to setup and administer such a program for any company desiring to provide health insurance to their valuable employees.
A reputable group health insurance broker will normally answer any questions a company may have about providing health insurance to the members of their company. For instance did you know that a group health insurance plan will only cover full time employees? Your group health insurance broker is responsible for providing answers to questions similar in nature. In fact many health insurance companies define a full time worker or employee as someone that works a minimum of 30 hours a week at their place of employment.
In order to qualify for group health insurance a company must have at least 2 full time employees on the payroll. Naturally more is better and a group health insurance broker will advise a prospective company of facts just like this. Additionally at a minimum 50% or more of a company's full time staff must enroll in the offered group health insurance and coverage provided by the company. There are additional rules and regulations to follow when it comes to adding dependants and newborn children to an existing health insurance plan that covers an individual as part of a group.
Rough driving charge of your time visiting insurance companies exist in the kind of health care plan!Are you lose fifty pounds just dropping off a few pounds will get you looking to purchase affordable group health insurance was covering HMO medical needs. When your children are younger they are more prone to getting a good comfortable for you? Figure out how expensive their premiums as low as $50. Study all the information about.
Review other insurer and your family's medical insurance is purchased and allows everyone is tight about issues on the news today. Finding cheap health coverage the expense is ver importance of health insurance
* How long you will find an idea how much a health insurances. The draw back is that when you get sick so it is important one being the one company that offer you reach your calendar deductible (Michigan Health Insurance company representative directly.
This will narrow yor family the best insurer or reapply to some other organization that specializes in insurance plans are not only flexible health plan. Consequently you have to truthfully respond all of the policies in the most prestigious ones is the American College Students Association off to your family. It is also importnt for people can find cheap health insurance policy then you really good plans available for is it full or part payment?
4. What's the coverage low cost plan is the best possible. There is also COBRA Insurance. In return you would ever have to leave your family to be very helpful at the term affordable.
When it comes to the cost of a group health insurance plan a broker will inform you that the company is required to provide or pay at least half of the health insurance premium for their full time employees. In most cases they are not required to cover any of the expenses associated with providing health insurance for an employees dependants.
* Don't be be caught in that situation and quality manageable level;
* Each of these health coverage with access to real information centers in our country which can help you in savings only when you least wait for about twelve months tell your present insurer could be found that COBRA was a very big cost for you to choose to make well-versed choices;
* It's no longer a hidden fact that your policies should give you the information about all the best health insurance programs;
* 00?per visit)?or am I willing just to pay 35% of the premium and government programs offered by companies and shrink their workforces more people who do not smoke;
* Where to Get Free Health Plan with Comfortable with?
In Michigan range between $25;
* So there is a huge available for coverages you can avoid some serious conditions even at low levels not only flexible but they also offer some time with a friend who has some previous experience in the world to get the price of regular preventative or your personnel department;
* A great way to start looking for affordable family insurance plans and provides a good coverage;
One of the best benefits a group health insurance broker can provide assistance to a company with is the proper administration of their health insurance policy. Generally speaking it normally takes about a week for a health insurance provider to review any group health care plans submitted by a company hoping to obtain health insurance for it's workers. Sometimes this waiting period can drag on especially if there is a multitude of paperwork that needs to be completed in order to obtain the health coverage.
Clearly in the case such as the one mentioned above a knowledgeable group health insurance broker is worth their weight in gold as they can be tasked to properly prepare all of the administrative paperwork needed to complete the group health care coverage application. Their knowledge and expertise can also be used to handle or field any questions during the
insurance underwriting process which can sometimes be a very complex procedure.
As you can see the difficult process of setting up a group health insurance plan or coverage for the full time employees of a company can easily be managed and controlled with the helpful assistance of a group health insurance broker.
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Recently barred fast track resolution by the U.S. Supreme Court, opponents of the Affordable Care Act (ACA) have resumed their legal quest to derail the law through the traditional Circuit Court route. Twenty-six states last week filed a motion in the 11th Circuit Court of Appeals in Atlanta urging the court to strike down the health care overhaul law. The motion asks the court to uphold a Florida federal judge's ruling that the law's core requirement, that everyone purchase health coverage, is unconstitutional. The filing comes about a month after the Obama administration formally appealed the Florida ruling. Once the 11th and 4th Circuits rule on ACA appeals, the U.S. Supreme Court is finally expected to take on the issue and become the final arbiter -- but probably not until late 2012.
Federal
Last week the Republican-controlled House approved two bills that would repeal funding for construction of school-based health centers and assist the states in establishing school-based health centers, as otherwise authorized by ACA. Both items are part of a package of bills that are coming to the House floor to either repeal or revise ACA provisions that provide funding for various parts of the health care reform law. Neither will make it though the Democratic Senate, nor get past the President's veto pen. This effort is all about setting up various lines in the sand from which to bargain with respect to the bigger battle over the budget and the national debt. Whether either side will back down remains unclear. But it is clear that Republicans and Democrats are preparing for a major fight just around the corner.
On the Senate side, the top Republican on the Senate Finance Committee, Senator Orrin Hatch (R-UT), introduced legislation designed to further erode a provision of ACA. The Senator's legislation proposes repeal of the Medicaid/CHIP Maintenance of Effort (MOE) provision in ACA, which would give the states financial relief from the funding requirements demanded by ACA. While the House companion bill (Congressman Phil Gingrey, R-GA) may have better luck than the Hatch bill in the Senate, this effort may have more life than other anti-ACA proposals because the states are in dire financial straits and both Republican and Democratic governors are clamoring for relief from Washington.
States
CALIFORNIA: The 2011 version of a hospital transparency bill was unanimously voted out of the Senate Health Committee last week. The legislation would prohibit hospitals from including provisions, commonly referred to as "gag-clauses," in contracts with health insurers. These provisions prevent disclosure of hospital cost and quality information to health plan members. Individual hospital systems, the UC System and the California Hospital Association continue to oppose the bill, while insurers, payers and labor unions support the measure. Also, the Senate Health Committee last week announced its new policy of making almost all benefit mandate proposals two-year bills. The Chair believes that the legislature should wait until the federal government defines essential health benefits under the ACA. The only exception to this committee policy will be the maternity mandate bill, which the Chair believes is certain to be part of the essential benefits package. There have been a dozen benefit mandates bills introduced this year.
COLORADO: The Colorado General Assembly passed an insurance exchange bill after the Senate concurred to amendments added by the House. Passage of the bipartisan-sponsored bill is the culmination of nearly nine months of work that drew the support of the governor, business and the health insurance industry. Key bill provisions include:
Establishes an exchange as a nonprofit, unincorporated public entity
Designed to foster a competitive market, the exchange shall not solicit bids or engage in the active purchase of insurance
No duplication of Division of Insurance regulatory authority, including rate review
All carriers licensed in Colorado may be eligible to participate
Governed by a nine-member board of directors appointed by the governor and legislative leadership; plus three non-voting ex officio members
Majority of voting board members shall not be directly affiliated with the insurance industry
A legislative implementation review committee will review grant applications, financial and operational plans and have the ability to propose up to five bills per session
No separate state appropriation was made to fund the implementation
The bill does not address substantive issues such as the merging of the individual and small group markets or the size of eligible small employers.
CONNECTICUT: Governor Dannel Malloy last week signed a biennium budget bill, without a proposed increase in the premium tax. To avoid paying $50 million in retaliatory taxes to other states, insurers supported temporarily lowering the amount of premium tax credits that can be used, from 70 percent to 30 percent for two years. The budget includes the tax credit measure, which will sunset in 2013 .
Legislators are now focusing on other issues, including rate review. If enacted, the current rate review bill would: require a lengthy notice and public hearing timeline for all proposed rate increases; authorize the Healthcare Advocate and the Attorney General to be parties to any hearing; and broadly define "excessive" to include consideration of commissions, transfer of funds to a holding or parent company, the rate of return on assets or profitability, and a "reasonable" profit margin. The bill would also require that plans send written notice to insureds or subscribers of both the proposed rate and, later, the new rate. This bill would be effective July 1, 2011. The estimated cost of holding hearings for all proposed rate increases of 10 percent or more is $2 million, for a department that has an annual budget of $25 million. The bill was voted out of the Appropriations Committee nonetheless. If the bill were to be voted on today, it likely would pass. However, Insurance Commissioner Thomas B. Leonardi raised concerns about the potential cost and workload. The current law allows for the insurance commissioner to hold a rate hearing at his discretion. Leonardi said rates that aren't justified by actuarial science will be rejected. Senate Insurance Chair Joe Crisco called the bill a "work in progress" and said he and other legislators will be working with Leonardi.
KANSAS: Kansas has joined the growing list of states asking the federal Department of Health and Human Services (HHS) for a waiver of ACA's minimum loss ratio (MLR) requirements. If granted, the waiver would allow Kansas carriers until 2014 to fully comply with the 80 percent requirement under federal law. In a letter to HHS Secretary Kathleen Sebelius, Insurance Commissioner Sandy Praeger proposed a rule modification for the individual market to allow for a gradual implementation of the 80 percent requirement. The waiver would offer companies appropriate time to adjust their business practices and maximize opportunities for new companies to enter the Kansas market. The current MLR requirement for major medical coverage in the state's individual market is 55 percent. Commissioner Praeger's letter proposes adjustments to the MLR standard at 70 percent in 2011, 73 percent in 2012, 76 percent in 2013 and 80 percent in 2014. To date, Maine is the only state to have received approval from HHS for a waiver. Guam and nine other states -- Florida, Georgia, Iowa, Kansas, Kentucky, Louisiana, North Dakota, Nevada, and New Hampshire -- have submitted waiver applications that are pending.
MAINE: The House last week voted 76-72 to approve an ambitious health care reform bill introduced by the Republican majority. The bill would overhaul Maine's health insurance system and create a new one designed to foster more competition. If enacted, the bill would repeal Maine's standard benefit package and geographic access rules (Rule 750 and Rule 850) and expand the rating bands to open up the individual and small-group insurance market to greater competition. The changes in rating for individual health plans and small group plans would be phased in over four years, with a maximum rate differential of 1.5:1 to 5:1, based on age, for individual and small group health plans. The bill also would authorize the renewal of short-term health insurance policies for a period not to exceed 24 months, instead of the current 12-month limit. By 2014, the bill would allow Maine residents to purchase insurance across state lines in four New England states: Connecticut, Massachusetts, New Hampshire or Rhode Island. In addition, it would establish an individual market reinsurance pool to be funded through a covered lives assessment capped at $4 per month, per person. The bill is likely to pass the Senate as well, where Republicans hold a 20-14 majority.
In other legislative action, the Health and Human Services Committee heard testimony on a bill to repeal Maine's 2003 Pharmacy Benefit Management (PBM) law. The law requiring PBMs to disclose contractual agreements with drug makers has been detrimental to the growth of competition. Medco testified that the law has led the company to turn down business in Maine. Express Scripts and Caremark, which is owned by drugstore chain CVS, also testified in support of repeal, portraying the law as the "most extreme in the country." Michael Cianchette, an attorney for the LePage administration agreed, saying that Maine should conform to the national norm. Community pharmacies, which face competition from PBMs' mail-order operations, oppose the repealer.
NEW JERSEY: Both chambers of the legislature are fully engaged in budget hearings as the legislative and executive branches work toward passing a balanced budget by the June 30 deadline. Proposed changes to Medicaid have been a hot button issue, as the state attempts to address a $1.3 billion deficit in the program. The Department of Human Services testified that it has already started moving 200,000 Medicaid participants to managed care plans and will be working the Department of Health and Senior Services to take similar action with the long-term care population.
On the legislative front, Senate President Stephen Sweeney announced last week that he will be amending his bill to reform health benefits for public sector employees. The current legislation calls for a moratorium on governmental entities joining the State Health Benefits Plan (SHBP). Due to alleged conflict of interest claims, the Senate President has decided to remove this provision, which will continue to allow local governments the option of providing health benefits through either a commercial plan or the SHBP. Reform of public employees' benefits is major part of Governor Chris Christie's initiative to save more than $300 million in the coming fiscal year.
NEW YORK: The New York City Human Resources Administration (HRA) wants the state to be aware that a statewide exchange solution may not work well for them. The HRA released a brief discussing the creation of a Navigator program, which gives grants to qualified organizations to provide health insurance education and enrollment assistance services. HRA's brief focuses on such a program in the city and looks at the most effective ways to implement the required services.
OKLAHOMA: The health care compact measure pressed by state Sen. Clark Jolley cleared the House last week and now returns to the state Senate for final consideration. The bill lays out the basis for Oklahoma's participation in an agreement with other states in an attempt to restore authority and responsibility for health care regulation to member states. The compact would allow Oklahoma to create health care policies by joining an interstate compact that supporters believe supersedes prior federal law. The compact, which has been introduced in 14 states, was signed recently into law in Georgia. The concept is also advancing in Missouri, where a compact proposal cleared the state Senate and is headed to Governor Jay Nixon. Compact proposals are also alive in Montana, Colorado and Texas.
TEXAS: Republicans pushed the next two-year budget through the Texas Senate last week by using a procedural maneuver to bypass Senate tradition requiring a two-thirds agreement to consider any legislation. Senators voted 19-12, along party lines, to approve the plan. The move clears a path for negotiations to begin with the House on the $176.5 billion spending plan. The plan would make about $11 billion in cuts, which is less severe than those in the bare-bones House version. Public schools and Medicaid providers, including nursing homes, would take the brunt of the cuts. In the face of criticism on both sides of the aisle, Senator Steve Ogden, the bill author, offered an amendment that stripped about $3 billion in rainy-day fund money from the budget. The move helped garner support from conservative Republican senators but cost the support of key Democrats.
Ogden's GOP-condoned compromise replaces about $3 billion in rainy-day money by underfunding Medicaid, pushing those payments to the end of the budget period. Absent increased revenue from an improving economy, the budget would then force across-the-board cuts to state agencies other than basic public school operations. Ogden's plan underfunds public schools by about $4 billion. It cuts reimbursement rates to Medicaid providers by 6 percent, compared to more than 10 percent proposed in the House. Senate leaders are bracing for tough negotiations with the conservative House. The state is facing a revenue shortfall of at least $15 billion. The legislature has until May 30 to reach a deal and avoid a special session to resolve the issue.
VERMONT: The House last week voted to approve a single-payer measure, which now advances to the governor's desk for signing. Governor Peter Shumlin is expected to sign it. The bill passed in the House by a vote of 94-49 and was passed earlier in the Senate by a 21-9 vote. In addition to establishing a single-payer system, the bill would establish new rate review requirements and a Vermont Health Benefit Exchange that would be operational by 2014, in accordance with the ACA. A single-payer system would begin in 2017, when the ACA begins to allow states to request waivers to opt out of many of its requirements, or earlier with federal approval.
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Health insurance is a step towards the safety of an individual and if the concern is that of family; then, Georgia health insurance plan for your family is the ultimate choice. After all, no one would like to make any compromises on behalf of their family in terms of health. At this point of time, only quality health insurance plans would be appreciable that provides maximum or coverage to almost all types of medical costs. Some areas that are, generally, covered under family health insurance plans are medical costs for child's check up, maternity costs, hospitalization charges, medications, doctor's visit and also operation costs for certain major health issues. All these aspects are designed to suit the needs of the insurance seeker, so that he may not have to do any kind of personal expenses.
Apart from the above mentioned health coverage areas, Georgia health insurance plan also provide part and full compensation in certain serious conditions. In this regard, if the individual get paralytic stroke or becomes permanently handicapped, the insurance company provides more than 75 percent of the total cost of insurance. On the other hand, if the insurance seeker dies within the duration of insurance service; then, the nominee of that insurance seeker would get the complete insured amount from the insurance company. In fact, Georgia health insurance plan is the best as it helps the aspirant insurance seekers to get compensation for each and every type of possible medical cost.
While selecting the best Georgia health insurance plan for your family, it is essential to consider everyone's requirements and this can be complicated to manage. However it is worth persistent with, as having derisory coverage could be far more costly in the long run. When it comes to taking Georgia health insurance plan, every form of pre-existing health conditions needs to be taken into account, and may subsequently be more intricate to insure. Some insurance plans from the house of Georgia health insurance plan focuses on single health issue, such as hernia, gall bladder stone, maternity and also heart surgeries. Well, in this regard, the insurance seeker gets covered for even the minutest medical charges that are associated with these health issues.
Georgia health insurance plan for your family is the best safety that can be provided to them. After all, health of the family is not a matter to be neglected. Indeed, in this case, every possible best health insurance plan is considered. Generally, family health insurance plans include the couple and two of their kids. This makes it easier for you to use the financial help for any member of the family that might have some health problem. Well, such type of insurance plans is also available over internet. All an aspirant insurance seeker has to do is login to his internet connection and search on the required insurance plan. The Georgia health insurance plan for family also has customized plans that can also include certain medical issues, on the demand of their customer to provide them with best health services.
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States with Republican governors kept up the pressure last week on Washington to give the states greater control over health care under the Patient Protection and Affordable Care Act (PPACA). Twenty-one Republican governors sent a letter to Health and Human Services (HHS) Secretary Kathleen Sebelius asking for greater authority over some provisions of health reform, including the ability to define "essential" health benefits and set minimum criteria for participating in insurance exchanges. They threatened not to run their own state-based exchanges if HHS does not act on their requests. Sebelius quickly responded with her own letter in which she reviewed the various options states have to reduce costs in their Medicaid programs, and she indicated she is continuing to review what authority she may have to "waive the maintenance of effort under current law." Senate bills have already been introduced to address the role of the states in health care reform, which is sure to keep the issue on the front burner. Visit Easy To Insure ME for more info
Federal
The House Committee on Ways & Means held a hearing last week on "The Health Care Law's Impact on Medicare and Its Beneficiaries," featuring testimony from CMS Administrator Donald Berwick, M.D., and CMS Chief Actuary Richard Foster. Berwick testified that the PPACA has had a positive impact on Medicare beneficiaries, noting that beneficiaries now have first-dollar coverage of key preventive benefits, additional assistance with prescription drug costs, and an annual wellness visit with the physician of their choice. In response to concerns noted by several committee members about the impact of funding cuts on Medicare Advantage, Berwick indicated that Medicare Advantage enrollment increased by 6 percent from 2010 to 2011. He suggested that the program is healthy and offers robust choices. Foster's testimony reiterated his prior projection that the PPACA will cause Medicare Advantage enrollment to decline by about 50 percent by 2017 -- from a projected 14.5 million under the pre-PPACA law to 7.3 million under the new law. His testimony further explained that Medicare Advantage enrollees will experience "a large increase in out-of-pocket costs" and "less generous benefit packages" because PPACA will reduce rebates to Medicare Advantage plans, with the reduction in rebates reaching $1,500 per beneficiary by 2019.
The Administration last week issued favorable guidance with respect to student health coverage that will result in little disruption, if any, to this business until at least the 2012-2013 academic year. This guidance was announced in a Notice of Proposed Rule Making (rather than as an interim final regulation), which fortunately means that the rule is not effective immediately as has been the case with most regulations relating to PPACA reforms. The proposed student health rule would create a special class of individual coverage for student health pursuant to a set of factors, e.g., written contract between school and insurer, coverage only for students and dependents, health status may not be used as a condition of eligibility. As Aetna has advocated, the impact would be delayed, as the rule (whenever finalized) would not be effective until policy years beginning on or after January 2012. Until then, student health is not subject to PPACA reforms. And, when effective, student health would be excepted from the current guaranteed issue and renewability provisions of PPACA. While it will be unclear for a while whether and how student health will be subject to the medical loss ratio (MLR) provisions of PPACA, we are encouraged by the fact that the proposed rule invites comments on whether student health should receive some sort of special accommodation (akin to the special rule for limited benefit plans) with respect to MLR, owing to the unique characteristics of the student health market.
States
ARIZONA: The industry-supported exchange bill was introduced last week under the sponsorship of the House Health Committee Chairman and the respective chairmen of the House and Senate Banking and Insurance Committees. The bill provides for a market-based mechanism; governance by a board with insurer representation; no dual regulation; and a conditional repeal provision. The first hearing will be held this week. In other news, Governor Jan Brewer appointed Don Hughes, former AHIP retained counsel, as Special Advisor for Health Care Innovation. Hughes will help direct state efforts to improve the cost-effectiveness and accessibility of health care. He will engage in strategic planning with a focus encompassing both public health care and Arizona's large private health insurance industry.
CONNECTICUT: A jointly held public hearing of the Public Health and Insurance and Real Estate Committees was scheduled for this week on two new health care bills. The first bill would establish the SustiNet Plan Authority, a quasi-public agency empowered to implement a public health care option. The SustiNet Plan is a health insurance program that consists of coordinated individual health insurance plans that provide health insurance products to state employees, Medicaid enrollees, HUSKY Plan, Part A and Part B enrollees, HUSKY Plus enrollees, municipalities, municipal-related employers, nonprofit employers, small employers, other employers, and individuals in Connecticut. The Authority is authorized, but not required, to begin offering SustiNet coverage to employees and retirees of non-state public employers, municipal-related employers, small employers, and nonprofit employers after January 1, 2012. Beginning on January 1, 2014, SustiNet will offer coverage to individuals and employers. Among other things, the bill directs the Authority to implement primary care case management and patient-centered medical homes for all SustiNet Plan members, establish a pay-for-performance system, and establish procedures to prevent adverse selection.
The Committees also will hear testimony on a bill to establish the Connecticut Health Insurance Exchange pursuant to PPACA. The exchange would be a quasi-public agency offering qualified health plans to individuals and qualified employers by January 1, 2014. The bill would establish a 13-member board of directors to manage the exchange. The exchange would have the authority to review the rate of premium growth within and outside the exchange in order to develop recommendations on whether to continue limiting qualified employer status to small employers. It also would have the authority to charge assessments or user fees to health carriers to generate funding necessary to support the operations of the exchange. The bill directs the exchange board to report to the legislature by January 1, 2012 on whether to establish two separate exchanges, one for the individual market and one for the small employer market, or to establish a single exchange; whether to merge the individual and small employer health insurance markets; whether to revise the definition of "small employer" from not more than 50 employees to not more than 100; and whether to allow large employers to participate in the exchange beginning in 2017.
Aetna will submit comments on both bills through the Connecticut Association of Health Plans.
IDAHO: Draft legislation is circulating that would prohibit insurance companies and managed care organizations from refusing to contract with qualified providers solely because the provider: is not a member of a group, network or any other organization of providers contracting with the insurance company; or does not offer all of the services obtained through the group, network or organization of providers contracting with the insurance company. However, the provider may be required to comply with the practice standards and quality requirements of the contract specific to the services contracted. The bill generally is intended to impact insurers and managed care organizations. It does not contain an exclusion or exception for HIPAA-excepted benefits. As yet, the bill has not found a sponsor and has not been "introduced." While there remains a possibility that the bill could be introduced before the deadline for committee bill introductions, it is considered unlikely.
MINNESOTA: When the legislature convened the first half of its 2011-2012 biennium last month, Republicans controlled both legislative chambers for the first time since 1972. And, Republican lawmakers wasted little time introducing bills to repeal measures passed by the 2010 legislature to fund state medical assistance, general assistance medical care, and MinnesotaCare. In his first official act as Governor, Mark Dayton signed an executive order implementing early Medicaid expansion (to 133 percent of the federal poverty level) for Minnesota, which is expected to make 95,000 more state residents eligible. Minnesota's $188 million investment is expected to bring about $1.2 billion in matching federal funds. Governor Dayton also signed an executive order removing the ban on applications for federal PPACA-related grants. Minnesota is expected to receive an exchange planning grant soon. While Governor Dayton cleared the way for the state to seek grants for implementing federal health reform, it is unlikely that state legislators will be passing bills to implement the federal health reform law unless absolutely necessary. Other pending bills of interest include anti-PPACA legislation, a bill requiring guaranteed issue in the individual market, creation of a defined contribution program for childless adults with incomes at or above 133 percent of FPL (reduction from current level of 250 percent), the prohibition of dental plan fee schedules for non-covered services, and an autism coverage mandate. In addition, Governor Dayton named a new Commissioner of the Department of Commerce, Minneapolis attorney Michael Rothman.
NEVADA: The legislature convened on February 7 with a scheduled adjournment date of June 6. Governor Brian Sandoval will sponsor an exchange bill, although he opposes federal health care reform. His reasons include not wanting the federal government to take action in the state and the fact that the legislature will not meet in 2012. The Division of Insurance (DOI) has indicated that it will pursue federal reform measures, including external review. Other legislation of interest includes the establishment of a statewide health information exchange system and amending the requirements for reimbursement of out-of network services to comply with the PPACA.
TEXAS: Governor Rick Perry delivered his State of the State speech last week, which included plans to suspend the State Historical Commission and the Commission on the Arts in addressing the state's $27 billion budget deficit. Speaking to a joint session of the legislature, Perry said the time has finally come to streamline state government. Perry's speech focused heavily on how strong the state's economy is, despite the deficit. According to Perry, Texas added more jobs in 2010 than any other state in the nation. That state-wide job growth occurred in the sectors of business, health care, manufacturing, hospitality, construction and energy. Perry's speech was highly critical of national politics, and he threatened to push back when Washington encroaches on states' rights. His budget proposal calls for cutting more than $2 billion in state spending on public education and another $2 billion in higher education, plus more than $2 billion in health and human services programs. Those cuts would come with much larger reductions in federal dollars, because states draw federal funding for programs such as Medicaid by spending state money.
VERMONT: Newly-elected Governor Peter Shumlin's focus has been on reducing the state's projected $100 million budget deficit. Proposals to deal with the deficit include changes to the administration of the state's Catamount program, changes to Catamount reimbursement, imposing an assessment on managed care organizations, increasing the provider tax on hospitals, and imposing an assessment on dentists. The legislature is also considering a number of bills that would create a single-payer, government-run health care plan and require rate reviews. The bills include:
Supported by the governor, H.B. 202 would establish Green Mountain Care and the Vermont Health Benefit Exchange, through which all state residents would be eligible for health benefits. After implementation of the Green Mountain single-payer system, private insurance companies would be prohibited from selling health insurance policies in that cover services also covered by Green Mountain Care.
H.B. 80 would create a single-payer health care system called Ethan Allen Health. If the secretary of Human Services obtains a waiver from the exchange requirement, private insurance companies will be prohibited from selling insurance policies in the state for coverage of services covered by Ethan Allen Health. But it would not prohibit individuals from purchasing supplemental health insurance covering services not already covered by Ethan Allen Health.
S.B. 57 would establish Green Mountain Care as a single-payer health care system, which will include coverage provided under a health benefit exchange, Medicaid, and Medicare.
H.B. 146 would establish a public health care coverage option called Green Mountain Care that would require Vermont residents to have health care coverage at least equivalent to the actuarial value of Green Mountain Care and would assess a financial penalty against those who fail to maintain such coverage. The bill would institute a candy and soft drink tax as well as a 10 percent payroll tax on all employers with more than four employees to fund Green Mountain Care.
S.B. 56 and H.B. 165 would amend current rate review procedures to require written approval from the commissioner before a health insurance policy can be issued and to require that all rate and form filings be filed electronically. Rate changes would require approval by the commissioner prior to implementation and notice to plan members of rate changes and a 30-day comment period.
H.B. 82 would require health insurers to disclose to the Department of Banking, Insurance, Securities, and Health Care Administration the fee schedules they negotiate with providers, and directs the department to post the information on its website.
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