[…] It’s always good to see new innovations that help to expand access to healthcare, and clinic memberships that allow people to cover their day to day medical expenses with a predictable annual fee and low cost appointments is likely to be quite popular, especially among people who can’t afford comprehensive health insurance. But as with any other product, a clear awareness of what you’re purchasing (or being offered, if an employer is covering the cost) will help to avoid future surprises.
colorado
Senate Bill 200 Begins The Process Of Creating Colorado Exchange
[…] Senate Bill 200 (the Colorado Health Benefit Exchange Act), co-sponsored by Senator Betty Boyd (D – Lakewood) gets the ball rolling on the health insurance exchange that the state will have to have in place by 2014. Specifically, the bill would create a “nonprofit unincorporated public entity known as the Health Benefit Exchange”. It includes guidelines for the appointment of a 12-member board of directors (9 of whom will be voting members) who will oversee the exchange, and lays out their responsibilities. […]
Good Reading At Grand Rounds And The Cavalcade Of Risk
[…] I wrote last fall about the new high risk pool in Colorado – GettingUsCovered – and how it differs from our existing high risk pool, CoverColorado (which has been operating for two decades). In states like Colorado that have existing state pools in addition to the federally-backed pools, there may be adequate options for people with pre-existing conditions, assuming that funding for both programs holds out until 2014. But in states that only have a PPACA-created pool, there are definitely some cracks to fall through, including the requirement that applicants be uninsured for six months before they can join the pool.
United HealthOne Finally Changes Initial Charge Protocol
Good news for those applying to United HealthOne:
Beginning with applications received on March 24, 2011, the processing of credit card or EFT payment will not take place until the application is approved and issued.
It’s about time. It was tough to explain to clients “and yeah, they’re going to charge you before they’ve even made a decision.”
New CoverColorado Provider Fee Schedule
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. […]
Makena – No Good Options For Health Insurers
[…] Over the last several years, most of the major health insurance carriers in Colorado have increased the out of pocket portion that an insured has to pay for prescriptions. Most individual policies now have prescription deductibles, and a lot of carriers have designated very expensive drugs as a separate tier that requires a percentage copay from the insured, rather than a flat amount. And of course, premiums continue to climb. The Makena story is an example of why this happens, and it has nothing to do with health insurance carrier profits. When insureds see their health insurance premiums skyrocket again, where do you think they will point their finger?
Does Colorado’s New Maternity Law Impact Underwriting?
[…] The language in the Division of Insurance FAQ page does seem to create some confusion on the issue. Stating that “A person who is already pregnant may obtain insurance at this time” could be interpreted in various ways… some might see it as saying that the person may obtain insurance if the carrier allows it (which none of them currently do), while others might see it as stating that the DOI interpretation of the law requires carriers to treat a current pregnancy as a specific exclusion rather than cause for an outright decline. […]
Maternity Coverage On Renewing Individual Policies
Since January 1, 2011, all new individual health insurance policies issued in Colorado have included maternity coverage as required by a new state law. The text of the bill was quite clear in stating that its provisions would apply to all “policies issued or renewed on or after the applicable effective date of this act.” (see the top of page 3 of the text). But until now, there was still some confusion around maternity coverage and policy renewals, and inconsistencies in how the law was being applied. […]
Using HRA Funds To Purchase Individual Health Insurance
[…] 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.” […]
HHS Proposes Waivers To Allow States Flexibility In Healthcare Regulation
[…] Colorado has been taking an active role in reforming healthcare for some time now. And our legislators are obviously still focusing on healthcare reform at a state level, from several different angles. Based on the initiative the state has shown over the last few years, I’m guessing that if the state waivers are available from HHS as of 2014, Colorado will likely take advantage of the opportunity to craft at least some aspects of our own healthcare regulation.
A Bill To Extend And Enhance The Regulation Of Midwifery In Colorado
I often write about bills in the Colorado legislature that pertain to healthcare, but Senate Bill 088 is one that is particularly important to me on a personal level. The law in Colorado regarding the regulation of direct-entry midwives is up for review this year. SB 088 renews the existing regulations, and would also allow direct-entry midwives in Colorado to provide some additional services, such as sutures and the administration of Vitamin K to newborns and RhoGAM to Rh- mothers. […]
Colorado Bill Would Allow State To Opt Out Of Federal Healthcare Laws
The Healthcare Opportunity and Patient Empowerment (HOPE) Act (HB 1273) was introduced in the Colorado House of Representatives this week, with primary House sponsorship from Reps Nikkel and Stephens (the House majority leader), and primary Senate sponsorship from Senator Kopp. The idea behind HB1273 is to allow Colorado to legally opt out of the PPACA – not just the individual mandate portion, but the entire law. […]
New Study Finds Healthcare Reform Will Benefit Colorado Economy
The New America Foundation (NAF) and the University of Denver’s Center for Colorado’s Economic Future recently published a new study in conjunction with The Colorado Trust and The Colorado Health Foundation. The study was designed to look at the projected economic outcomes for the state of Colorado with and without health care reform. For the reform scenario, the researchers concentrated on the recommendations created by the Colorado Blue Ribbon Commission (208 Commission) a few years ago. They compared that data with the projected outcomes if we do nothing and simply maintain the current system with regards to health care. […]
SB 168 Introduced With Goal Of Creating Colorado Health Care Cooperative
In a continuation of the string of healthcare-related legislation we’ve seen recently, Colorado Senate Bill 168 was introduced earlier this week. SB 168 would create a nonprofit healthcare cooperative to act as the benefits administrator and payer for health care services in Colorado. Similar to several other healthcare bills we’ve seen over the years, this one would implement change in a multi-step process: first by creating a proposed Colorado Health Care Authority, which would design the cooperative and take it to the legislature and then voters for approval. […]
Student Health Insurance And The PPACA
[…] Today, HHS has proposed additional regulations specifically aimed at student health insurance policies, in order to make sure that those plans meet the guidelines created in the PPACA. In essence, it would define student health plans as “individual health insurance coverage” and would eventually obligate student health plans to meet the same requirements as any other individual policy. […]
Smart Medicine
[…] We cannot continue to tackle the health care mess by focusing on health insurance reform. That has been a large part of the focus of debate over the last couple years, mainly because health insurance is the point at which most people interact with the financial aspects of their health care. But health care costs are what drive health insurance premiums, and there’s no getting around that. It’s refreshing to hear the President of the Colorado Medical Society talking about the need for evidence-based medicine and a general scaling back of what we spend on health care. […]
Peace Of Mind With Automated Payment Of Health Insurance Premiums
[…] If you sign up for automated payments, there’s nothing to remember. You don’t have to worry about your health insurance lapsing because a bill didn’t arrive, or because you forgot to send in a check. You don’t have to worry about making a typo or accidentally sending an underpayment. And in a lot of cases it’s less expensive to have automated payments set up too – some carriers charge an additional fee if you opt to receive a bill and mail a check for your premium.
Is Colorado Representative’s Information Based On Email FWD?
Last week, the House of Representatives voted to repeal the PPACA. One of the Representatives voting for repeal was Scott Tipton, a Republican from Colorado’s 3rd congressional district. Obviously each Representative had to vote according to his or her own conscience and the general consensus from constituents, but one would also hope that prior to voting, each Representative would clearly understand the facts surrounding the various issues within the law. […]
Colorado Senator Introducing Legislation To Study Health Care
Colorado Senator Irene Aguilar, a Democrat from Denver, will be introducing legislation next month to address the fact that there are still 700,000 people in Colorado without health insurance. Although Colorado has made strides recently in areas like the expansion of Medicaid, we didn’t even come close to fulfilling former Governor Bill Ritter’s hopes for health insurance for all Colorado citizens by the end of 2010. […]
Removing HSA Contribution Cap Does Not Solve Any Health Care Problems
[…] People who already max out their HSA contributions and still have money left over to contribute more would likely appreciate the removal of the HSA contribution cap. But those are not the people who are struggling to afford health insurance or pay for medical care. They are not the people our elected representatives should be focusing on when coming up with solutions for health care reform. Although I like our HSA and the flexibility it gives us to save for future medical expenses, I acknowledge that HSAs are not a panacea for what ails our health care system. […]
Colorado House Bill 1025 Would Repeal Health Care Affordability Act
[…] HB 1025, introduced by Colorado Springs Republican Rep Janak Joshi, would repeal the Health Care Affordability Act of 2009 (HB 1293). That Act introduced the Hospital Provider Fee system to generate about $600 million annually in funds for the expansion of Medicaid, the Colorado Indigent Care Program (CICP) and Child Health Plan Plus (CHP+). Those funds are supplemented with federal matching of an additional $600 million for the expansion of those programs in Colorado. The Health Care Affordability Act was widely supported by hospital and medical groups in the state. […]
Few Carriers Offering Child Only Policies During Open Enrollment
[…] You can still get quotes for child-only plans, but the only options that will appear on quote engines that work with major health insurance carriers are Rocky Mountain Health Plans, and Kaiser Permanente for people in the Denver/Boulder area. We wanted to clarify this point in case there is confusion surrounding the open enrollment period. It’s unknown whether the other major carriers will be able to find a way to make child-only coverage a profitable venture as time goes by, but for now, the options are still quite limited in the child-only market in Colorado, regardless of the open enrollment window.
Colorado Bill Would Allow Employers To Reimburse Employee Premiums
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). […]
Health Care Costs Are The Driving Factor Behind Premium Hikes
I’ve long supported the idea that our health care system was in need of reform that would make care more affordable and accessible to everyone, regardless of their health or financial situation. But I’m starting to feel a bit frustrated by what feels like an over-emphasis on regulation of health insurance carriers and not enough focus on ways to actually control the cost of health care (including over-utilization). If people are thinking of this process as health insurance reform rather than health care reform, it’s doomed to failure. […]
United HealthOne Plans Available in Colorado on January 13th
United Health has notified us that they’re ahead of schedule and will have rates, plan descriptions and applications ready by January 13th. Quotes and applications for United Health medical can be done here. Quotes and applications for dental and vision can be done here.