Phia Group Russo & Minchoff

I Hope Trustmark Tells HHS to Go Pound Sand

cmonfils | January 22, 2012

Today, the Department of Health and Human Services announced that, “Trustmark Life Insurance Company has proposed unreasonable health insurance premium increases in five states—Alabama, Arizona, Pennsylvania, Virginia, and Wyoming. The excessive rate hikes would affect nearly 10,000 residents across these five states.” 

Affordable Care Act holding insurers accountable for premium hikes

cmonfils | January 22, 2012

Health insurance premium increases in five states have been deemed “unreasonable” by the U.S. Department of Health and Human Services, HHS Secretary Kathleen Sebelius announced today. 

After independent expert review, HHS determined that Trustmark Life Insurance Company has proposed unreasonable health insurance premium increases in five states—Alabama, Arizona, Pennsylvania, Virginia, and Wyoming.  The excessive rate hikes would affect nearly 10,000 residents across these five states. 

States Move To Implement Health Reform Provisions

cmonfils | September 19, 2011

www.hr.cch.com

CCH® BENEFITS — 09/01/11
from Spencer’s Benefits Reports: According to the Kaiser Family Foundation’s State Health Facts, 23 states have established American Health Benefit Exchanges under the Patient Protection and Affordable Care Act (ACA), have enacted legislation with the intent to establish an Exchange, or have Exchange legislation pending.
Massachusetts and Vermont have established Exchanges, while California, Colorado, Connecticut, Hawaii, Maryland, Nevada, Oregon, Vermont, Washington, and West Virginia have enacted legislation to establish an Exchange. Hawaii’s Exchange will be a nonprofit, Vermont Exchange will be operated by the state. The rest of the Exchanges will be quasi-governmental.
The Exchange will be a clearinghouse and contract with all qualified health plans in Colorado and Hawaii. In California, Connecticut, Oregon, and Vermont, the Exchange will be an active purchaser contracting with selected health plans and/or negotiating premium prices with health plans. The other states have not yet decided the type of Exchange they will operate.

In Illinois, Indiana (by executive order of the governor), North Dakota, and Virginia, legislation has established the intent to set up an Exchange, while Alabama (by executive order of the governor), Georgia (by executive order of the governor), Mississippi, and Wyoming will study the feasilibility of an Exchange.
The District of Columbia, New Jersey, North Carolina, and Pennsylvania have Exchange legislation pending.
For more information, visit http://statehealthfacts.kff.org/comparemaptable.jsp?ind=962&cat=17.
Rate Review Programs
The federal government will either conduct or assist health insurance rate reviews in nine states, according to the most recent fact sheet from the Center for Consumer Information and Insurance Oversight (CCIIO), which discusses the rate review requirements included in the ACA.
According to the CCIIO, as of Aug. 15, 2011, state rate review procedures were as follows:
  43 states, the District of Columbia, and one U.S. territory have effective rate review in at least one insurance market;
  41 states, the District of Columbia, and the U.S. Virgin Islands have effective review for all insurance markets and issuers.
  In two states (Virginia, Pennsylvania), the federal government will partner with the state to conduct reviews; and
  The federal government will conduct reviews in seven states (Wyoming, Montana, Missouri, Louisiana, Idaho, Arizona, and Alabama) and four U.S. territories (American Samoa, Guam, Northern Marianas Islands, and Puerto Rico) until those areas are able to strengthen their review processes and authorities.
Starting Sept. 1, 2011, insurers seeking rate increases of 10% or more for non-grandfathered plans in the individual and small group markets are required to publicly disclose the proposed increases and the justification for them.
For more information, visit http://cciio.cms.gov/resources/factsheets/rate_review_fact_sheet.html.

State Health Care Reform Update

cmonfils | April 8, 2011

www.hr.cch.com      CCH® BENEFITS — 04/04/11

from Spencer’s Benefits Reports: For the last few years, states have been leading the way toward more comprehensive health care coverage to ensure that more people have or can obtain health insurance. With the passage of federal health care reform, states will have increasing responsibilities in regard to employer-provided health insurance benefits. Spencer’s Benefits Reports continues to provide regular updates about state health care reform. (more…)

States Rejected Federal Funds to Administer a High-Risk Insurance Pool

Adam V. Russo | June 28, 2010

Twenty states so far have rejected federal funds to administer a high-risk insurance pool, as designed by the Patient Protection and Affordable Care Act. The high-risk pool would extend coverage to state residents unable to purchase insurance because of preexisting medical conditions. In these states, the federal government will be responsible for creating and running a high-risk pool on behalf of the state, as mandated by the Affordable Care Act. The 20 states are: Alabama, Arizona, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Louisiana, Minnesota, Mississippi, Nebraska, Nevada, North Dakota, South Carolina, Tennessee, Texas, Virginia, West Virginia, and Wyoming. Two states, Oregon and Utah, have not indicated whether they will be running their own high-risk pool or if they will let the HHS run it for them. The remaining 28 states have decided they will run their own temporary high-risk pool. For more information, visit http://www.hhs.gov/ociio/initiative/hi_risk_pool_facts.html. (more…)

Wyoming

Adam V. Russo | November 13, 2009

Wyoming’s House Bill sought to amend worker’s compensation statutes reducing subrogation recoveries for the injured party’s attorney’s fees. The bill ordered “Any recovery by the state shall be reduced pro rata for attorney fees and costs in the same proportion as the employee is liable for fees and costs.”