Monday, October 12, 2015
The news can be so depressing. Bad news 24/7. It is hard to believe, based on what is reported on FOX, MSNBC, or even CNN, that anything is getting done in Washington. And that is why I am particularly happy to devote today’s blog post to some good news.
President Obama signed into law H.R. 1624 last week. Yes, there are laws, bipartisan laws, getting through Congress. The Protecting Affordable Coverage for Employees (PACE) Act is legislation that will allow states to define the size of small groups for health insurance purposes.
The Patient Protection and Affordable Care Act (PPACA) changed the size of small groups from 2-50 to 2-100 as of January 1, 2016. The new regulations, especially community ratings, have the potential of eliminating group health coverage for hundreds of thousands of employees and their families. The PACE Act fixes the problem.
Many of my readers and clients wondered why I went to Washington in February. “Why waste your time and money?” they asked. PACE was one of the major issues on our agenda. Our elected representatives paid attention to me and my peers because they understood that we were there in Washington for our clients, not ourselves. We were able to impress upon them that fixing this and other issues didn’t mean that they agreed or disagreed with Obamacare. This was just constituent service.
This bill was sponsored by Representatives Brett Guthrie (R-KY-2) and Tony Cardenas (D-CA-29) in the House and Senators Tim Scott (R-SC) and Jeanne Shaheen (D-NH) once it got to the Senate. The President quietly signed the PACE Act into law Wednesday evening. The House, the Senate, and the President stripped the politics out of this and simply worked together to get something done. This is proof that our leaders are still capable of working in our best interest.
Our other big issue is “Grandmothered” policies. These are the policies that were issued with an effective date between April 2010 and December 31, 2013. I have mentioned that my personal health policy would be twice as much under the new law. Twice as much, over $600 per month.
The good news is the “Grandmothered” policies are still around for another year. The renewals are coming in and the rates are still terrific. Agents and our trade groups are committed to fighting for our clients and the option to retain these older, more affordable policies. And just like PACE, we know that the key to success is getting Congress to understand the scope of the problem.
The PACE Act may be the feel good story of 2015.
Friday, October 2, 2015
The check came in the mail earlier this week. My check. Made out to me personally. And I couldn’t be happier. One of the most touted provisions of the Patient Protection and Affordable Care Act (PPACA) is the MLR, Medical Loss Ratio. This check was my rebate.
The PPACA requires an insurer to issue a rebate to each client if it does not spend at least 80 percent of the premiums it receives on health care services. Allowable services include actual medical claims, activities to improve patient safety, and efforts to improve health care quality. The other 20% may be used for administrative costs, salaries, advertising and agents.
Last year my insurer, Anthem Blue Cross Blue Shield spent only 79.70% of a total of $340,647,389 of premium dollars on health care. They had to issue rebates since they fell .30% short. My check, my share of this windfall was $7.90.
I think I’ll go to Vegas.
Photo credit - Jeff Bogart