COBRA Subsidy Extension Announced

Cobra-Insurance

Yesterday, President Obama signed into law H.R. 3324, the Defense Appropriations Act that included a provision to extend federal COBRA premium subsidies.  Currently, it applied to those that involuntarily lost their coverage and were eligible for COBRA to 12/31/09.  The extension makes that timeframe 02/28/10.  It also extend the time period for which a subsidy can be given from 9 months to 15 months. In addition, the legislation would give beneficiaries whose subsidy expired and who didn’t pay the full premium the opportunity to receive retroactive coverage. For example, a beneficiary whose nine months of subsidized coverage ran out November 30 and who didn’t pay the unsubsidized premium for December could pay his or her 35 percent share in January and receive COBRA coverage for December.  The legislation makes clear that employers can offset future COBRA premiums or issue refund checks for beneficiaries who overpaid their COBRA premium. That could happen if a beneficiary whose subsidy ran out in November paid the full premium rather than the 35 percent share in December.

 There are additional notification requirements for those who formerly, currently, or prospectively elect COBRA continuation.  The Department of Labor has not published a model notice yet. 

COBRA subsidy expansion from HR 3324

Jeff Seiler Offers Insight to the Harry Reid Health Care Plan

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Jeff Seiler, an insurance consultant from Illinois, sent the following email this morning:
 
See below from NAHU which is important:
Here is my little summary:
 
I was also able to scan through about 100 pages of the Manager’s Amendment- otherwise known as Harry Reid‘s personal gift giving for votes. I’m sure no one really read the Manager’s Amendment of 383 pages , which are convenient changes to the real bill (over 2000 pages), but much of it is citing only certain paragraph changes. (Making it incomprehensible to anyone wanting to know what either the real bill or Manager’s Amendment says in total.) Then I got sick to my stomach (i have a strong stomach, so it took a while). Aside from give-aways to Nebraska, etc…here are some things I found to scare the crap out of you:
 
*Definitions of what will and will not be covered medical expenses….setting the stage for government definition of a full health plan and deciding ultimately all of your benefits.
 
*Defines that insurance must cover clinical trial participation in phases I toIV (basically forcing coverage of unproven and very expensive treatments that may not work). That alone will drive up costs substantially.
 
*Calls for investigation of self-funded plans and why they are more efficient, but basically setting up the premise that these plans provide inadequate coverage and are usually less expensive due to claim denials. Believe it or not, there is actual wording in there to that effect, so you know where that is going….bye bye self-funding.
 
*Provides that plans must notify participants of the appeals process in- believe it or not- culturally and linguistically appropriate methods….can anyone imagine how many languages we now must accomodate?
 
*Sets up Multi-State exchanges using non-profit companies (not many of those, so you know who wins here), but the plans offered must be available in all 50 states by the 4th year of their existence.
 
*Penalizes by $600 per employee any large employer who has a waiting period for coverage longer than 60 days-thereby forcing empoyers in high turnover industries to cover employees and incur liability for people who may never really contribute to the bottom line (after hiring and training costs).
 
*Sets penalites for not getting coverage (unConstitutional) and then sets them so low that people will not buy coverage until they need it and will drop off once they don’t need it—thus driving up costs even further.
 
*Cites the disaster of the Massachusetts plan as being successful (when it is clearly not) as reason to incur this disasterous plan.
 
The Manager’s Amendment is also filled with lies about the cost of coverage and what the bill will accomplish as justification for the measures. Harry Reid looks like he is just as good at being a liar as the guy in the White House. Talk on Capital Hill is that the Senate bill will be the one that they pass…they won’t even look at the House bill, since it took so many favors to get the Senate one through, that any changes would stop final passage. therefore, they expect the House to eat crow and vote for this. It’s time to double up pressure on the House.
 
Editor’s Note: Jeff Seiler’s website is; www.ssbenefits.net
 
 

Medical Loss Ratio Restrictions Will Kill Insurance

AnAnA
IHC Group
 
 
Say ‘No’ to Medical Loss Ratio Restrictions in Health Bill

An early-morning vote Monday means the Senate health care bill could face a final vote as early as December 24th. Certain portions of the bill are problematic for our industry, in particular, the manager’s amendment that would increase mandatory medical loss ratios (MLRs) to 85 percent for large groups and 80 percent for individuals and small group.
 
We encourage you to contact your senators today. Please read this message from the National Association of Health Underwriters, and contact your senators using letter that appears along with it. Simply fill out your information and click send. 
 
While we know this is a busy week for many, we must respond quickly. Sending this letter will only take a moment and will make an important impact on your future. Please take action before December 24th.
 
Thank you for your continued support and for vocalizing your concern regarding issues that affect our industry.
 

Sincerely,
Jeff Smedsrud
Co-president
The IHC Group fully insured operations