Consumers raise concerns with CT insurance exchange

Consumers and small businesses had a rare opportunity to share their concerns with CT’s health insurance exchange Friday. A standing room only crowd met with the exchange’s CEO, Kevin Counihan at a restaurant in Glastonbury. Christie Hager, HHS Regional Director, also attended. Comments focused on the lack of consumer and small business input to the exchange, inappropriate influence of insurers, and the exchange staff’s decision not to negotiate with insurers to get the best value for customers. Through negotiation, MA’s exchange has been able to keep the rate of premium increases to half what it is outside their exchange. However prices in Utah’s exchange, which does not negotiate with insurers as CT’s exchange is planning, are actually higher than prices outside the exchange. CT’s exchange is being set up by the state, with millions in federal grants, to help consumers get decent, affordable coverage and is expected to purchase on behalf of one in ten state residents. As of Jan. 1, 2014, everyone in CT will be required to have coverage. Residents who qualify for federal affordability subsidies will have to buy their insurance through the exchange. Check back at the CT Health Policy Project’s site soon for a brief on the benefits for CT consumers, promoting value and affordability, through negotiation on CT’s exchange.

CT exchange staff won’t negotiate with insurers on behalf of consumers or small businesses

Staff of the CT Health Insurance Exchange have “opted to utilize an ‘any qualified plan’ approach” for determining which plans can be offered in the exchange. Proposed qualifications are minimal and generally only what is required by the Affordable Care Act. This decision is counter to the CT exchange’s own research. According to the market consultants, “One of the most attractive aspects of the Exchange is that the big insurance companies compete for their business. The feature evoked references to Lending Tree’s slogan ‘When banks compete you win.’” Utah’s health insurance exchange has pursued an “any qualified plan” approach, similar to CT’s staff proposal, and has attracted little enrollment with no evidence of cost control. Massachusetts’s Connector, on the other hand, operates with an active purchasing approach – negotiating with insurers to get the best price and quality for consumers. Annual premium increases for plans in Massachusetts’s exchange have been half the increase of plans outside the exchange. Starting in 2014, every CT resident will be required to secure health coverage. Over 150,000 state residents will have to buy it in the exchange to get federal affordability subsidies. According to the staff memo, the decision not to negotiate on behalf of consumers has been made and they are only taking comment on how to implement that policy. The memo was delivered Monday to the Qualified Health Plan Committee that no longer includes a consumer representative due to the unfortunate loss of Jennifer Jaff.

Private Health Insurance Exchanges––Will They Save Money? Will the Idea Grow?

Private health insurance exchanges will save employers money but not make health insurance cheaper.

Because private health insurance will save employers money, they will grow.

Will Private Insurance Exchanges Reduce Health Insurance Costs?

There's lots of buzz these days about private insurance exchanges. The idea is to give employees more choice in purchasing their own individual coverage

CT still earns a C+ on reform

Once again, CT health care thoughtleaders give our state a C+ on health reform. From the beginning of the CT Health Thoughtleaders Survey in February, CT has varied between C and C+. CT has always received a B for effort. In good news, grades for the CT Health Insurance Exchange improved since June with fewer D’s and some A’s in this survey. Unfortunately, grades for Engaging Consumers in Policymaking and Data-based Policymaking have fallen. The former was the most common recommendation from thoughtleaders to improve progress toward reform. The overwhelming response was to engage consumers in policymaking – increase consumer voices, greater public engagement in the process, and engage advocates. Other suggestions included smarter policymaking (data, best practices), improve communications and transparency, convene stakeholders to build trust, and guard against conflicting financial and special interests. New questions in this survey found that almost all thoughtleaders are somewhat or very engaged in the process of reform, however all but four cite barriers to engagement. Understanding how critical stakeholder engagement will be to success, policymakers should work to improve effective, meaningful access to the process. A disturbing number of respondents have not been asked, or have tried but found few ways to participate. The Thoughtleader Survey is part of the CT Health Policy Project’s Health Reform Dashboard project at www.cthealthreform.org.

No More Phony CA Health Exchange Web Sites - CA AB 1761

We've all seen them.  Web sites touting themselves as the "California Health Exchange" or something similar.  Some provide a disclosure (usually at the bottom and often in small type) that the site is, in fact, an insurance agent's web site and is in no way actually affiliated with the 'real' CA Health Benefits Exchange.  Lately I have seen a couple with no disclosure at all.  

Well, that party is now over in California and those of us who have been following the HBEX (Health Benefits Exchange) knew it was coming.  

On September 30, 2012, Governor Brown signed into law California Assembly Bill 1761.  The bill, now law, prohibits agents (and other entities) from claiming any affiliation with the CA HBEX as well as any advertising including social media that makes any such claim.  It is now against the law in California for an agent or agency to pretend that they are somehow representing or affiliated with the California Health Exchange.

From AB 1761:

(j) Holding oneself out as representing, constituting, or
otherwise providing services on behalf of the California Health
Benefit Exchange established pursuant to Section 100500 of the
Government Code without a valid agreement with the California Health
Benefit Exchange to engage in those activities.

This bill would prohibit an individual or entity from holding
himself, herself, or itself out as representing, constituting, or
otherwise providing services on behalf of the Exchange unless that
individual or entity has a valid agreement with the Exchange to
engage in those activities. The bill would specify that it is an
unfair business practice for health care service plans, entities
engaged in the solicitation of health care service plan contracts,
and persons engaged in the business of insurance to violate this
provision. Because a willful violation of the provisions governing
health care service plans is a crime, the bill would impose a
state-mandated local program. [emphasis is mine]

I expect that agent marketing guidance will be forthcoming from the HBEX or the Insurers next year as we prepare for the initial open enrollment beginning October 1, 2013.  As of today, we have not received any information on either certifying for the exchange or what specific agent marketing will be allowed.  All agents selling HBEX plans to the public will be required to be certified with the CA exchange prior to engaging in any sales activity.

In the meantime, if you run across any sites that are not the official exchange web site, you know that the site is not approved and that the agent is committing a crime by pretending to be or be affiliated with the CA HBEX.

Dave

www.davefluker.com

As always, for specific health insurance information please visit my web site.

Will Many of the Smallest Employers Circumvent the Affordable Care Act by Using Self-Insurance?

Not surprisingly, only about 10% of firms with fewer than 200 workers take advantage of self-insurance––and almost no very small groups (fewer than 50 workers) use the product. It just isn't worth it for these small employer groups to take the risk that they will either have too many claims or very big claims from their workers––that is what insurance companies are for.

Already, 96% of workers