Senate Bill HR 3590

[Crabcake Johnny]

The clause I was looking for - page 157

ENROLLMENT THROUGH AGENTS OR BROKERS.—The Secretary shall establish procedures under which a State may allow agents or brokers (1) to enroll individuals in any qualified health plans in the individual or small group market as soon as the plan is offered through an Exchange in the State; and (2) to assist individuals in applying for premium tax credits and cost-sharing reductions for plans sold through an Exchange. Such procedures may include the establishment of rate schedules for broker commissions paid by health benefits plans offered through an exchange.

This is different language from the House bill which makes no mention of commissions. In this bill each state "may" set the rate of commissions.
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VERY interesting:

Page 38:


1) INFORMING SECRETARY OF PREMIUM INCREASE PATTERNS.—As a condition of receiving a grant under subsection (c)(1), a State, through its Commissioner of Insurance, shall— ''(A) provide the Secretary with information about trends in premium increases in health insurance coverage in premium rating areas in the State; and ''(B) make recommendations, as appropriate, to the State Exchange about whether particular health insurance issuers should be excluded from participation in the Exchange based on a pattern or practice of excessive or unjustified premium increases.

Wow!!! This gives the states a large amount of power about which carrier can sell in the exchange.

Per this clause, if the state wants the grant (which they need) they'll have to review all past carrier's premium increases. If they deem them "unjustified" they have the power to exclude that carrier from participating.

This is what I call the "state revenge" clause for association-based carriers. If this passes, every 2nd tier carrier will crap their pants.

 

[ins.dave]

The clause I was looking for - page 157

ENROLLMENT THROUGH AGENTS OR BROKERS.—The Secretary shall establish procedures under which a State may allow agents or brokers (1) to enroll individuals in any qualified health plans in the individual or small group market as soon as the plan is offered through an Exchange in the State; and (2) to assist individuals in applying for premium tax credits and cost-sharing reductions for plans sold through an Exchange. Such procedures may include the establishment of rate schedules for broker commissions paid by health benefits plans offered through an exchange.

This is different language from the House bill which makes no mention of commissions. In this bill each state "may" set the rate of commissions.
- - - - - - - - - - - - - - - - - -
VERY interesting:

Page 38:


1) INFORMING SECRETARY OF PREMIUM INCREASE PATTERNS.—As a condition of receiving a grant under subsection (c)(1), a State, through its Commissioner of Insurance, shall— ''(A) provide the Secretary with information about trends in premium increases in health insurance coverage in premium rating areas in the State; and ''(B) make recommendations, as appropriate, to the State Exchange about whether particular health insurance issuers should be excluded from participation in the Exchange based on a pattern or practice of excessive or unjustified premium increases.

Wow!!! This gives the states a large amount of power about which carrier can sell in the exchange.

Per this clause, if the state wants the grant (which they need) they'll have to review all past carrier's premium increases. If they deem them "unjustified" they have the power to exclude that carrier from participating.

This is what I call the "state revenge" clause for association-based carriers. If this passes, every 2nd tier carrier will crap their pants.

I can hear Milton Friedman roll'n around in his box.