Zinser Benefit Service - Small Business Insurance

Individual Insurance, Group Insurance and Employee Benefits, small business insurance

Silver Oak Form CRS

Humana

President Obama’s Announcement

· · Leave a Comment

This was sent to me in an email from Humana – gives a nice summary of President Obama’s announcement last week about keeping your current coverage.

 

The biggest news in the health care arena has been President Obama’s announcement regarding the treatment of discontinued 2013 health plans.

Policy holders across the country have been receiving letters from their health insurers telling them their current health plans do not comply with the health reform requirements that go into effect on Jan. 1 because (1) they don’t meet the reform law’s new minimum benefit requirements, and (2) they aren’t eligible to be grandfathered (regulations allowed for some old health plans to be locked in). The notifications affected individual and small business health plans.

Some health insurers like Humana, where it was permitted under state law, gave policy holders a choice.

  • They could “early renew” their current, non-health reform compliant coverage, which meant signing up for a year-long policy before the end of 2013.
  • They could end their current coverage at the end of the year and sign up for a new reform-compliant version of their health plan for 2014.
  • They could compare other options on the health insurance marketplace.

Many other insurers simply explained that policy holders’ current coverage was being cancelled.

The arrival of those letters took many Americans by surprise, since the President had repeatedly promised, “If you like your health plan, you can keep it.”

So last Thursday, the President responded to the public and political pressure to make his promise true. “I’m offering an idea that may help,” he said: He proposed that for 2014 – one year – health insurers be allowed to continue to sell health plans that were due to be cancelled at the end of 2013. “State insurance commissioners still have the power to decide what plans can and can’t be sold in their states,” Obama explained. “There’s going to be some state-by-state evaluation of how this (proposal) is handled.”

  • The industry group America’s Health Insurance Plans (AHIP) immediately released a statement saying, “Changing the rules after health plans have already met the requirements of the law could destabilize the market and result in higher premiums for consumers.”
  • The National Association of Insurance Commissioners released a statement reiterating AHIP’s concerns and added, “It is unclear how, as a practical matter, the changes proposed today…can be put into effect,” since rates and plans for 2014 had already been approved in many states.
  • Insurance consultant Robert Laszewski explained the challenge in a note to clients: “This means that the insurance companies have 32 days to reprogram their computer systems for policies, rates and eligibility, send notices to policyholders…ask the consumer for their decision…and then enter those decisions back into their systems.”
  • An analyst with Citigroup wrote in a report, “The complexity of trying to uncancel millions of canceled individual policies with only six weeks left in the year is staggering.” He predicted the “enormous administrative burden” would mean many insurers would choose not to extend coverage.

As the New York Times wrote, “It remained unclear just how much impact the fix delivered by an apologetic Mr. Obama would actually have. …There is no guarantee that insurers will…allow people to stay on their existing plans…or that states will allow such renewals.”

Some health plans may have an easier time than others implementing the President’s proposal. Humana, for example, has already reached out to members in states where permitted and offered them the option to retain their current health plans, extending their current coverage to the end of 2014.

States are reacting to the President’s announcement in different ways. For example, the insurance commissioners in the states of Rhode Island and Washington immediately responded they would not follow the President’s proposal to allow the continuation of 2013 policies into 2014. Kentucky and Ohio said they would work to help health plans provide their members with the option of renewing their 2013 policies.

The executive director of the industry group California Association of Health Plans said he was opposed to the idea of reversing course. “The entire underlying premise of the ACA – balancing costs of the young, old, sick and healthy – has been left adrift with this announcement,” he said.

Kentucky Health Benefit Exchange

· · Leave a Comment

We are a week away from the Kentucky Health Benefit Exchange.  I’m in the process of completing the training in order to sell in the exchange.  Hopefully rates will be available soon.

kynect.ky.gov

 

 

Modified Community Rating

· · Leave a Comment

This week’s Business First of Louisville had an article about Modified Community Rating.  Director of Government Relations Lawrence Ford is quoted throughout the article.

Here’s the link:

http://www.bizjournals.com/louisville/print-edition/2013/05/24/modified-community-rating-system-is.html

Mr. Ford does a good job of explaining how this will impact Kentuckians rates.  He highlights two issues.  The first is younger people subsidizing the older population.  Insurance companies aren’t going to bring down older folks rates, they’re going to push the young population up to help offset the older population claims.  He also talks about the lack of a substantial penalty for those who don’t enroll.

Still something needs to be done about letting individuals buy whenever they get ill.  The way it’s currently set up that is what could happen.  I know there are talks about it, but we need something done soon before Jan 1, 2014.

Follow Up Post to The Cost of Health Care

· · Leave a Comment

As a Board Member of our Professional Association (Greater Louisville Association of Health Underwriters, or GLAHU) I’m currently Co-Chair of our Media Relations.  I try to submit something monthly, and especially when there is a major story on health care or health insurance.  I think I’ve had at least three in the paper over the course of my time (since 2008).   I had one get published on a Sunday (that’s the one that I received the most comments about, I think three people said something to me, all over the age of 60! Go figure…Ha Ha).

So, the process is when I see something, I send it to our National Association, and I ask them to put something together, or I work with them, but usually Kathryn at NAHU always gives me something great.

This morning I submitted the below editorial to the Courier-Journal.  I’ve had good luck in the past getting in, so let’s hope we get another one!

Dear Editor,

A recent article reported that hospitals across the country are charging “wildly varying amounts for common major medical care” (“Costs for same medical procedures vary widely at Louisville hospitals,” May 9). Even the director of the Center for Medicare and Medicaid Services, Jonathan Blum, questions the validity of the practice.

 

The healthcare law’s efforts to improve access to insurance are admirable, but the problem isn’t limited to the cost of health insurance. If we continue to ignore this “cost shifting” in hospitals as well as other pricing issues with pharmaceutical companies, healthcare equipment providers, medical malpractice suites and other causational factors, coverage will remain unaffordable. Addressing the system’s cost drivers is crucial to preventing that unfortunate outcome.

M. Zachary Zinser

Media Relations Co-Chair

Greater Louisville Association of Health Underwriters

 

Kentucky Expands Medicaid

· · Leave a Comment

Yesterday Governor Steve Beshear announced Kentucky’s decision to expand Medicaid.  A link to the article in the Courier-Journal is below:

http://www.courier-journal.com/article/20130509/PRIME07/305090046

Figures from the 2012 U.S. Census Bureau tells us that 308,000 Kentuckians will now be eligible for this coverage.  The next step is for these newly eligible citizens is to enroll.  The National Association of Health Underwriters (NAHU) have always touted that many uninsured citizens could obtain coverage if they were to sign up for it.  Some citizens don’t even know that they’re eligible for “free” coverage.  Hopefully this will change.

Another point to keep in mind with this expansion is that hopefully Employer Based premiums will be lowered because these premiums have a “tax” included that helps offset the bills for the uninsured.  Hopefully that will be removed.

Let’s also hope that these newly enrolled citizens will start using their insurance.  One problem that uninsured people encounter is that they wait to get their healthcare.  By waiting, they’re more likely to seek service in the Emergency Room, which is the most costly place to seek service.  Now that they have Medicaid, hopefully they will seek preventive care and stay out of the Emergency Room.  Opponents have said this will flood doctor’s offices.  I guess we’ll have to wait and see.

The last point I’d like to cover is what kind of impact will this have on Employers.  Under this Expansion, a single person making up to $15,856 annually, will be eligible for Medicaid.  This is just a tick above the minimum wage level (assuming a 40 hour work week).  Something that I’d like to know is how many Kentuckians with full-time employment (under the new law that’s over 30 hours per week) would qualify for Medicaid.  These newly eligible citizens maybe considered a  “Qualified Waivers” to an Employer Sponsored Plan.  A Qualified Waiver is someone that has coverage elsewhere under another insurance plan.  An example would be someone today being covered under their spouse’s plan.  The employer doesn’t have to cover that spouse, and the employer isn’t harmed in their participation percentage with their health insurance company because the employee is covered under a spouse’s plan.  I know, it’s confusing.  The point is (and I’m still waiting for insurance companies to verify this, although today this is accurate) that these newly Medicaid eligible recipients will now be considered a qualified waiver in an employer sponsored plan.  How many new Medicaid recipients make this amount of money and work 30+ hours for one employer?

 

Request a Quote

Call (502) 245-6674 for more information or Request a Quote online.