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Health Insurance

Another insurance deadline only days away

More than 20,000 Georgians have until next Friday to provide missing information or they will lose their insurance exchange coverage Sept. 30.

Renard Murray

Renard Murray

The regional administrator of the federal Centers for Medicare and Medicaid Services told GHN on Friday that most of the data discrepancies involve immigration or citizenship issues.

Letters requesting further information were mailed earlier in August to 310,000 people in three dozen states that have their insurance exchange run by the federal government. The exchanges were created under the Affordable Care Act.

Georgia’s total of 20,900 people getting the notices was the third-highest total in the nation, after Florida’s 93,800 and Texas’ 52,700.

Renard Murray, the regional CMS administrator, said the federal agency has been working on getting this information for months, and that as many as seven letters requesting data have been sent to some people. full story

Key activist group sees flaws in state health plan

Last week, when upcoming changes in the state employee and teacher health plan were announced, they drew a generally positive response.

Healthcare CostMembers learned that the 2015 plan would include an increased choice of insurers, which was welcome, and officials presented information showing that many members would see no premium increase.

But after studying the proposed rates in greater detail, a group representing teachers, employees and retirees is voicing concern. It says many of the new options will be unaffordable for members looking to switch from their current plans. full story

State health plan choices for 2015 draw praise

Many state employees and teachers will see no increase in their health insurance premiums next year under rates approved by a state agency’s board Thursday.

The State Health Benefit Plan members will have choices among plans offered by three health insurers, rather than a single insurance company this year.

The SHBP covers 650,000 state employees, teachers, other school personnel, retirees and dependents. With those numbers, the members of the health plan have proved to be a potent political force in this election year.

Sarah Lesley and her daughters joined a Capitol rally in February against the design of the state health plan.

Changes in the health plan that started Jan. 1 triggered fierce criticism from members, who complained about a lack of choice of insurance plans and higher health care costs. A Facebook group (Teachers Rally to Advocate for Georgia Insurance Choices, or TRAGIC) attracted thousands of members. Teachers and state employees rallied at the state Capitol, protesting the new health plan design.

TRAGIC members Thursday praised the wider health plan options.

“I’m glad to see we have a choice,” said a member of the group and a retired Marietta teacher, Julie Jarrett, after the Department of Community Health board vote Thursday. (Community Health oversees the state health plan.)

Many SHBP members had trouble understanding the 2014 Health Reimbursement Arrangement (HRA) and how it worked, Jarrett added.

“I’m happy they’re going to educate all the members what the HRA really is,’’ Jarrett said Thursday. “They didn’t do that last year.” full story

Insurers to pay $11 million in Georgia rebates

A federal rule on health insurers’ spending will bring $11 million in rebates to Georgia individuals and employers this summer.

Federal figures released Thursday show that 304,000 Georgians will benefit from the refunds, with an average rebate of $53 per family, as a result of the “Medical Loss Ratio” (MLR) rule on 2013 insurance plans.

1088819262-1249Created by the Affordable Care Act, the MLR standard generally requires health insurers to spend at least 80 percent of the premium dollars they collect on medical care or activities to improve the quality of health care.

In Georgia, $5.5 million will go to refunds to 180,000 individual consumers, while $5.4 million will go to employers in the small-group market. In both these sectors, the required threshold is 80 percent.

The large employer market, where the minimum requirement is 85 percent, accounts for just $270,000 in refunds in Georgia for last year’s health plans.

Humana plans in Georgia will have to pay the highest amount in rebates — $4.5 million combined in the small-group and large employer market. full story

Exchange subsidies draw conflicting court rulings

More than 190,000 Georgians are enrolled in the health insurance exchange created by the Affordable Care Act.

But if a D.C. federal court ruling announced Tuesday on exchange subsidies is ultimately upheld, that Georgia number could shrink precipitously.

Healthcare Cost

The U.S. Court of Appeals for the District of Columbia ruled Tuesday that the language of the ACA allows subsidies, or discounts, only for people who obtain coverage through exchanges run by the states, and not by the federal government.

Georgia is among 36 states whose insurance exchanges are federally run.

About 95 percent of Georgians enrolled in health plans in the exchange have received subsidies to help them afford their premiums, according to the state insurance department.

The 2-to-1 ruling by a three-judge panel of the court — if not overturned on appeal — would be a tremendous setback for President Obama’s health care law.

Without subsidies, the price of health insurance for millions of people in Georgia and the 35 other states with federally run exchanges would rise sharply, making it generally unaffordable.

The judges suspended their ruling pending an appeal by the administration. The Obama administration said it would appeal to the full circuit court, a process that could take up to six months, and stressed the ruling would have no impact on consumers receiving monthly subsidies now, Reuters reported.

Also Tuesday, a three-judge panel of the 4th U.S. Circuit Court of Appeals in Virginia ruled unanimously to uphold the subsidies provision, saying the wording of the law was too ambiguous to restrict the availability of the funds. The ruling was announced shortly after the D.C. decision.

 

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