Pre-existing Come 2014

[bill3173]

At the Hearing before the Senate Finance Committee on 2/14/2013, Mr. Cohen from CCIIO said that HHS would be releasing final regs on EHB's (those regs came out this week, by the way), and then insurance companies can make final design changes to their plans. Then in March and April, insurance companies will send those plans and the rates to the govt for approval, and in July the approvals should be finished.

I didn't mean anything quite that formal, just that the carriers have people that are very skilled at costing the plan designs, and have had ample time to get within a couple of points of what the cost per insured will be, etc. and have certainly passed that info. on to the Gov. by now.

I don't think the "final" regs should create sticker shock for the White House. Not after all this time has passed.

 

[Ann H]

Yes, the govt agencies are bound to know it's going to be rate shock. The Senators were talking about it in the hearing, and in HHS's recent final rule on the EHB's they admitted that the mandates may be "economically inefficient".

 

[ctg]

The carriers I represent claim the plans sold now are compliant. With EHB's in place for 2014. But if final regs just came out, how can they be certain?

 

[somarco]

In states where the Feds are running the exchange, the states gave up rights to approve the plans for the exchange.

Maybe one of us is missing something, but I am under the impression the state DOI still has to approve any and all filings pertaining to the policies regardless of who is running the exchange.

Also need to consider non-HIX policies will probably have different benefits, rates, networks and Rx formulary's.

This is no small task and most state DOI's are understaffed.

You would think the Sec. of HHS, a former insurance commissioner, would know this stuff.

Of course maybe she was commissioner in name only and had no clue how the department worked.

 

[Ann H]

Maybe one of us is missing something, but I am under the impression the state DOI still has to approve any and all filings pertaining to the policies regardless of who is running the exchange.

You may be right. I was under the impression that the Feds approved all plans for the exchange, and the state approved all plans outside the exchange, in FFE states. However...... this is not an issue where I feel certain of my facts. I may very well be wrong about that, Bob.

 

[VolAgent]

You may be right. I was under the impression that the Feds approved all plans for the exchange, and the state approved all plans outside the exchange, in FFE states. However...... this is not an issue where I feel certain of my facts. I may very well be wrong about that, Bob.

There is your next headache. What is the Feds approve the plan, but the state's don't? Are you still liable in state criminal and civil court if you sell a plan that has been approved by the Feds but not the state?

 

[somarco]

What is the Feds approve the plan, but the state's don't? Are you still liable in state criminal and civil court if you sell a plan that has been approved by the Feds but not the state?

I know the future has been projected to be like MAPD, and that may be so.

But MAPD plans are still approved at the state level with federal oversight on so many levels I can't count them all.

 

[taterpeeler]

The carriers I represent claim the plans sold now are compliant. With EHB's in place for 2014. But if final regs just came out, how can they be certain?

I have spoken to several agents that I have known for years that in some way have "tied" to MGA's and every single one of theses agents are being pumped with the BS that all things will be fine, the plans they are selling are just going to keep on kepping on......WTH? and they believed it......

 

[ctg]

Yeah, it sucks to have to look my client in the eye, shrug my shoulders and say "I don't know. Nobody does."

I don't like to have to use the terms "at this point", "as I understand", "this may change", "depending on what the government does" "insert your own here".

I'm confused, the informed consumer is confused. It's hard to keep up with a moving target. The uninformed consumer is in for an awakening.

 

[stuy119]

I'm confused, the informed consumer is confused. It's hard to keep up with a moving target. The uninformed consumer is in for an awakening.

Don't worry, they can talk to an unlicensed and uninsured (E&O) navigator for advice.