As of April 1, 2011, CoverColorado will be switching to a new fee schedule for reimbursing providers. In the past, CoverColorado has used the Rocky Mountain Health Plans provider network, and doctors were paid according to the RMHP network-negotiated rates when they treated CoverColorado members. The new CoverColorado-specific fee schedule applies to any provider who treats a CoverColorado member, regardless of whether that provider is part of the RMHP network or not. […]
[…] However, it appears that the Colorado Division of Insurance has repealed its 2009 order regarding the use of HRA funds to purchase individual health insurance. Final Agency Order O-11-064 details the questions involved (including issues regarding eligibility for CoverColorado) and concludes that “Self-funded employee benefit plans sponsored by a private company such as an HRA, are employee benefit plans under ERISA and are not subject to the jurisdiction of the Commissioner.” […]
The 2011 Colorado legislative session is now underway, and Senate Bill 19 will be particularly interesting to watch. Since 1994, Colorado has had a law that bans employers from reimbursing employees for individual health insurance premiums. If any portion of the premiums for such plans are paid or reimbursed by the employer, the Colorado Division of Insurance considers the employer to have created a small group health insurance plan, and the plan must adhere to small group regulations (this impacts things like underwriting, and also has tax implications for the employer). […]
[…] As of last week, the number of waivers granted by HHS has grown to 222, and more than 1.5 million plan enrollees will continue to be covered next year by policies that provide limited benefits, despite the fact that those policies do not conform to the PPACA rules. Some of the exempted plans cover only a few workers, but some have thousands of enrollees. […]
[…] I can’t imagine huge numbers of people simply opting to be uninsured if employers stop offering coverage, especially once individual health insurance is guaranteed issue and pre-existing conditions are no longer an issue. I would guess that in 2014 we will see at least some shift away from employer-sponsored coverage in favor of individual health insurance, but I imagine that plenty of employers will continue to offer at least some level of coverage as a way to attract and retain quality employees.
This article is not the first I’ve seen that calls into question whether Obama was being truthful when he said that health care reform would be structure so that people would still be able to keep their existing health insurance if they wanted to. And it would seem that his statements did amount to a bit of over-promising. But even before the PPACA came up for a vote, many Americans weren’t in control of whether or not they got to keep their existing health insurance. […]
For nearly two decades, Cover Colorado has been providing health insurance to people in Colorado who don’t have access to group health insurance coverage and have pre-existing conditions the make them uninsurable (or unable to get coverage without exclusion riders or rate increases that put their premium above that offered by Cover Colorado) in the individual health insurance market. While we’re lucky to have such a resource, it doesn’t come cheap […]
[…] We work with individual health insurance, so my knowledge of workers’ comp issues are generally limited to what I read on Julie’s blog. But I find it interesting that workers’ comp is relatively inexpensive here, given that our health insurance premiums put us right in the middle of the national ranking in 2009, and group health insurance premiums here are currently rising faster than the national average.
A survey conducted by the Lockton Benefit Group found that premiums for employer-sponsored group health insurance policies in Colorado were increasing by an average of 14.4% for 2011, which was “significantly higher than reported nationally.” This was the tenth year in a row that premiums saw double digit increases, but the current increase is the largest in five years, and most employers surveyed (more than 73%) plan to make plan changes or increase employee contributions to offset the large rate increases. […]
[…] The extra $1000 per worker that Wal-Mart is planning to contribute to the HRAs will definitely help employees to offset routine costs, and will hopefully encourage more of them to enroll in the company’s health insurance policy. But it will still be a struggle for many families to come up with the rest of the high deductible in the event of a serious illness or injury, if the family relies on wages from Wal-Mart to cover all of their living expenses.
[…] Copays and deductibles have risen for most families over the last few years, even those who don’t have policies that qualify as high deductible. And at the same time, economic stability has decreased for most families. This isn’t a good combination, and Joe’s right about the fact that when people skip necessary routine medical care, it will likely lead to increased medical costs (and declining health) in the future.
Earlier this summer, HHS announced that businesses could begin submitting applications to the newly-created Early Retiree Reinsurance Program in order to receive federal funding to help pay for retirees’ health insurance until they become eligible for Medicare. To date, 2000 businesses have been approved for the program, and HHS Secretary Kathleen Sebelius says that this is just the beginning. Businesses have shown great interest in the reinsurance program… […]
[…] most non-elderly Americans still get their health insurance through their employers. And in general, as long as people are somewhat satisfied with the status quo, most of us tend to be a bit resistant to change. Obviously, people who are currently uninsured are likely to support sweeping changes in the health care system. But most Americans do have health insurance, and those who have generous policies – that are at least partially funded by their employers – might find themselves with less coverage if we moved to a single payer plan.
Several provisions in the new health care reform law will begin to take effect next month. More changes will take place over the next three years, leading up the biggest changes in 2014, when all individual policies will have to be guaranteed issue, and everyone will be required to have health insurance.
The only way an insurance policy will be able to avoid some of the changes implemented by the new law is to retain grandfathered status, basically by keeping the policy mostly unchanged from the way it was on March 23, 2010, when the law was passed. But it turns out that the benefits […]
[…] We still have several months left in 2009 for regulators and insurance companies to work out the details, and I’m sure we’ll know more by the end of the year. When you combine this with the new Colorado law banning gender rating on health insurance policies, and the myriad of reforms coming from the federal government, I’d say that health insurance regulators in Denver are going to have their hands full for a while.
[…] There are an estimated 62,700 people in Colorado who retired before they were eligible for Medicare and are receiving retiree health care benefits from their former employers. Their employers can now apply for financial assistance to help cover the cost of health care for their early retirees, and the financial assistance can be passed along to the retirees in the form of lower health care costs.
[…] It remains to be seen how health care reform will actually impact the breakdown of individual versus group health insurance. Currently, there are far more people with group coverage than individual policies. The balance might shift a bit as health care reform takes effect, but I doubt that there will be a mass exodus away from group plans in favor of individual coverage.
[…] Will guaranteed issue health insurance – and subsidies to help pay for it – starting in 2014 also help to decrease the number of people receiving SSDI? If people had a way to obtain affordable health insurance without having to qualify as disabled, it stands to reason that there would be more incentive for people to return to work after a serious illness or injury.
Three of the nation’s top health insurance carriers – Wellpoint, United Healthcare, and Humana – have announced that they will automatically keep young adults under the age of 26 on their parents’ policies between now and September 23, when the health care reform legislation guarantees this option for all everyone under the age of 26. […]
One of the aims of the health care reform legislation is to encourage employers to provide health insurance for their employees. In order to close the loophole that would allow employers to hire many part-time workers (and avoid paying benefits for them), the new law looks at the total number of hours worked to determine “full time equivalent employees”. On page 309-310 of the Senate Bill, the math is explained: […]
[…] All individual health insurance applications in Colorado ask a set of questions to determine if the applicant qualifies as a group of one. If the applicant does, and is declined for the individual coverage, the insurance carrier must offer group of one coverage instead (although it will be significantly more expensive than the individual policy). If the person does not meet the definition of a group of one, he or she will be sent a notice by the insurance carrier regarding eligibility for Cover Colorado.
[…] Another question we’ve had recently has to do with lifetime and annual benefit maximums. So I read those sections of the Senate Bill and the changes added during reconciliation, to get a good understanding of exactly how the new legislation will impact individual health insurance policies. […]
One of the provisions in the health care reform bill allows children to remain on their parents’ health insurance policies until the age of 26. You may recall that a couple of years ago, Colorado passed a law allowing children here to remain on their parents’ policies until the age of 25, so the new law won’t have as much of an impact here as it will in states that currently boot young adults off of their parents’ coverage at younger ages. […]
[…] His Plain Language In insurance bill passed out of the House last week, and is headed for the Senate this week. It would require that all auto, dental, long term care, and health insurance policies sold in Colorado be written at no more than a 10th grade reading level starting in 2010. It would also require that all the fine print be no finer than a 10 point font. […]
[…] Individual health insurance is a great option for people who are healthy, and especially those who are relatively young… But the price increases with age, and many early retirees find it a challenge to pay for health insurance during the years before they are eligible for Medicare. My guess is that even if private individual policies could be purchased by people over the age of 65, very few people would take that option, simply because of the price.