HEALTH INSURANCE EXCHANGE

May 13, 2010

HHS Issues Interim Final Rules for PPACA Early Retiree Reinsurance Program

Filed under: HHS, PPACA, Retiree Reinsurance Program — Tags: , , — admin @ 5:25 am

As you are aware, an Early Retiree Reinsurance Program was included as part of the Patient Protection and Affordable Care Act of 2010 (PPACA). Last week, Health and Human Services (HHS) announced the interim final rules detailing employer requirements to qualify for the $5 billion program funding.

The reinsurance program applies to employer-sponsored fully insured and ASO plans that offer health benefits to retirees age 55 to 64 years old, but not Medicare-eligible, and their spouses and covered dependents. It allows plans to be reimbursed for 80 percent of certain claim expenses per individual per plan year.

The following are key points from the interim final rules:

  1. Claim expenses incurred prior to June 1 for the current plan year as of June 1, will count toward the threshold of $15,000; however, only claim expenses incurred on or after June 1 will count toward the limit for the plan year for a given individual.
  2. Plans may be reimbursed for 80 percent of certain claims between $15,000 and $90,000.
  3. The program will end on Jan. 1, 2014, or when the $5 billion funding runs out, whichever occurs first.
  4. Employers must use reimbursements to reduce the cost-sharing requirements of participants in early retiree plans and/or to reduce plan expenses to provide the coverage.
  5. Applications will be available in late June 2010 and HHS will certify, through the applications, the plans eligible to participate in the program.
  6. Eligible program claims include: medical, surgical, hospital, and prescription drug.
  7. Claims paid for diagnosis, care, mitigation or prevention of physical or mental diseases or conditions are eligible for reimbursement.

April 8, 2010

Health Insurance Exchange Hearings April

After a lengthy debate in special session, the legislature voted along party lines to permit lawsuits challenging the newly enacted federal health insurance reform law. It is unclear whether Governor Jan Brewer will join other states in the lawsuit filed in Florida health insurance, since the attorney general has advised that he will not advise in any litigation on this issue. Brewer has asked lawmakers for authority to go around the attorney general and sue on the state’s behalf.

A bill prohibiting the use of gender as underwriting factors in setting rates for individual policies passed both chambers and will become effective with plans issued or renewed after January 1, 2011. The bill is part of Governor Ritter’s health insurance reform package.

A bill that originally would have imposed a tax on health insurance plans – the language regarding a health plan tax was removed recently — was passed out of the Senate last week. However, whether the Governor will sign the bill in its current form is unclear.

The House has unanimously passed the Illinois Health Exchange and Technology Act to establish authority to operate the Illinois Health Information Exchange. Expected to pass in the Senate, the bill supports the adoption of electronic records among health care providers in Illinois, and building the infrastructure necessary to make it possible.

Pulling attention away from the legislature’s individual health market reform bills, Governor Jennifer Granholm implemented an executive order that put into motion a cabinet level work group titled “Health Insurance Reform Coordinating Council” on federal health care reform issues to be implemented in Michigan. Her goal is to identify steps that must be taken to ensure that Michigan citizens reap  full benefits outlined in the federal reform bill.

Last week, the Senate Committee on State Affairs held a joint hearing with the Senate Committee on Health & Human Services to discuss the impact of federal health care reform. The committee heard from Health & Human Services Commissioner Tom Suehs, Texas Department of Insurance Commissioner Mike Geeslin and Special Projects Director Dianne Longley, and the Employees Retirement System. Suehs estimated the cost to the State would total $27 billion over 10 years. When asked why his estimate was so much higher than that of the CBO, Suehs stated that “I know that I’ve got a higher population of uninsured than most states have total population.” Commissioner Geeslin focused his opening comments on the massive scope of the bill and how much change it will bring to consumers. In response to a question, Geeslin said that a new rate review authority could respond to a rate increase they deemed unjustified not with an enforcement action but only to inform the public that the rate increase was deemed unjustified. He also pointed out that the state can opt out in 2017 if it can demonstrate that it could provide similar coverage. He clarified that the exchange function could be outsourced but not to a Medicaid agency or a private insurer. Both agency heads confirmed that their need to add staff to implement the law will be substantial. The Committee members were in agreement that many future hearings would be required to keep up with the pace of reform implementation.

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