6/10/10
Dear MAHU members,
On Friday, Pat Pennefather, Cathy Cooper, Gary Reed and I had a meeting with Commissioner Ken Ross and Deputy Commissioner Joan Moiles to discuss the implementation of various aspects of PPACA. We discussed the following areas:
Health Insurance Ombudsman: This is a work in progress that hasn’t had very much movement as of yet due to more pressing issues. We took the time to explain that members of MAHU act as this for our clients everyday and that we would really like to be involved in the development of the position within OFIR
Minimum Loss Ratios: Commissioner Ross indicated that they are still waiting on the development of this data from both HHS and NAIC. We expressed that this is of great concern to MAHU members since this is how we are compensated for providing the service. We told him that the NAHU leadership has been working closely with HHS in the development of what goes into the MLR calculation.
High Risk Pool: We were informed that an RFP is going to be going out next week to interested parties which appear to be the HMO plans and BCBSM. The time allowed for response has been shortened due to the time requirements for the establishment of the HRP. They hope to have chosen a partner or partners by Mid July. The HRP will abide by the PPACA guidelines with an estimated Open Enrollment to begin on September 1st with coverage being effective on October 1st. More details about the plans and particulars will be coming out once the RFP process is completed. When we asked about agent commissions for the HRP plans, we were told that the carrier or carriers that offer plans will use the same distribution channels they use now for Individual products. Some of the criteria for enrollment in the HRP is:
· Person must have been without insurance for 6 months
· They must be a legal resident of Michigan
· They must have a pre-existing condition
· They don’t have to have been denied in the standard market
· There will be only one product design offered
When asked about how the funding would be done once the $140m of Federal money ran out, the Commissioner stated that they HRP would be limited to a certain number of slots within geographic areas and then would be closed down. We are concerned about whether this is allowed within the rules of PPACA. I’ll be sending an email up to NAHU to get some further clarifications on that issue.
Web Portal: The State and the Insurance carriers have the responsibility to provide HHS with the information that will be loaded into the Web Portal that is supposed to be up and running by July 1st. They have no idea if this will actually be functional by the July 1st PPACA deadline.
Exchanges: We have provided OFIR with information regarding the Utah and Massachusetts Exchanges as OFIR is currently awaiting additional guidance and regulations from the NAIC and OFIR. This is really in the infancy stages as far as they are concerned.
MAHU will continue to keep you updated as progress continues on these topics.
Respectfully,
Michael A. Embry, RHU
Legislative Chairperson
Michigan Association of Health Underwriters
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On May 5, 2010, Janet Olszewski, Director - Michigan Department Community Health, testified before the Senate Health Policy Committee. Her testimony was on the federal healthcare reform and its impact on Michigan. You can view her presentation by clicking the icon to the right.
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