Federal Risk Pool

[SusieQ2]

Changes to the Pre-Existing Condition Insurance Plan in Your State | HealthCare.gov

Compare this to the risk pool in Texas, especially if you have a smoker.

However, I've been told that even if the doctors are listed as being in the network they are hesitant to take it because the government is running it and they seem to think they won't get paid.

 

[Crabcake Johnny]

Here's the relevant part:

Increasing Outreach with Partners

"Beginning this fall, HHS will begin paying agents and brokers for successfully connecting eligible people with the PCIP program. This step will help reach those who are eligible but un-enrolled. Several States have experimented with such payments with good success. This is a part of continuing HHS outreach efforts with states, insurers, providers, and agents and brokers to reach more eligible people and let them know that coverage is available. HHS is working with insurers to notify people about the PCIP option in their state when their application for health insurance is denied."

Don't gloss over the importance of HHS admitting that they need to pay brokers for this program to pick up on enrollment numbers.

 

[AndreaSti]

Looks like but I am not sure, are they going to start paying agents in every state come fall? And what will they pay? We currently have a link on our quotit engine that people can use to apply for PCIP but no pay for us. At least it is set up already. So far no one has applied through us, we haven't had a client that could afford it. 15% decrease in GA, maybe they will apply now. Although some folks won't apply until it is free.

Of course none of this matters if docs won't accept it.

 

[Crabcake Johnny]

It reads "HHS will start paying agents." To me that means we'll get compensated for enrolling people into the pool even in states that don't administer their own risk pool.

In some states, like FL, a 40% reduction is significant. Currently I'd pay $211 (I'm 44.) After the 40% reduction I'd only pay $126.

 

[AndreaSti]

Question - did they lower the rates already? I can't tell and it doesn't say unless I missed that part of it. It just says it WILL be changing, not when. I see the part where on July 1, in some states (not sure which ones) people can get a letter from their doc instead of a denial letter to qualify. Also, I am assuming the 6 month waiting period is still in place.

 

[TXINSURANCE]

The big difference is the Texas Health Insurance Risk Pool as a 12 month wait on pre ex if you have more than a 63 day gap in coverage. The Federal pool has NO wait on pre ex however you can not apply if you have had health insurance in the past 6 months (Penalty for being responsible).

So how much is the PCIP commission? Anyone want to get some side bets going? I say $25...

 

[SusieQ2]

Difference in premium in Texas is astounding. A 60 year old smoker would pay $1,400 plus for a $2,500 deductible in the 750 zip code. Non smoker is still over $1,000.

With the Federal Pool they would pay $426.

How many average Americans can afford that kind of premium?

I guess the six months without insurance is to keep them from all running from the Risk Pools.

 

[TXINSURANCE]

Maybe if they were not 60 years old, uninsurable and smoking...

 

[AllenChicago]

The thing I still don't understand is why HHS allowed states to choose to administer the PCIP in the first place. Illinois is one of those states. HHS dropped the PCIP price an average of 23% on 1/1/2011. The states (like Illinois) that administer the PCIP themselves did NOT have to follow suit and lower the premiums. In fact, Illinois decided not to lower the premium. It's exactly the same today as it was in September 2010.

I helped a lady submit an IPXP (Illinois admin PCIP) application in January 2011. To this very day, the state of Illinois still hasn't processed/approved her. They've asked for additional documents, but no decision. Illinois is CRAZY.

HHS should rescind the ability of the states to administer the PCIP. In fact, when I get home, I'm writing a letter to HHS advising them to do just that.
-Allen

 

[Yagents]

First, the $100 enrollment fee doesn't start for 4 months on 10/1/01 because they need to change one small item. What a crock of sh**. I'd hate to see what a health exchange will look like in 27 months. Also, amazing that they can change prices in 23 states within 30 days, but can't put a place for name/address/producer# on app for 120 days.

On a more positive note, we need to recognize this is an opportunity to show all the powers that be, that agents do make a difference. So, just go about biz as usual, and let's send them a ton of biz after 10/1 to show them we can make a difference in the exchanges. Unless the new agent section comes out quicker than stated. Yagents