For industry outsiders, you need to know that a typical insurance company needs at least a year to plan and implement a new health insurance product. Guess what? They’re not going to get it.
By John Goodman Filed under New Health Care Law on November 21, 2012 with 7 comments
For industry outsiders, you need to know that a typical insurance company needs at least a year to plan and implement a new health insurance product. Guess what? They’re not going to get it.
With the national health law’s political future now entrenched, a deluge of new rules is expected in the coming days and weeks as the Obama administration fleshes out the law’s complex components…
For the administration, some of the trickiest decisions concern how insurance policies must be designed, priced and sold starting next October, when open enrollment begins for the new online marketplaces, called exchanges, that will offer plans to individuals and small businesses. For instance, the law allowed insurers to alter their prices for people based on their age, family size, where they live and tobacco use. The Department of Health and Human Services has to determine how insurers can go about setting those prices…
The government also has to specify how cost-sharing rules for consumers will work, and what types of medical services must be covered in health plans sold in the exchanges. Twenty-six states have already chosen an existing health plan as a benchmark identifying what “essential benefits” their state’s insurers must provide. In those states that don’t establish a benchmark, the administration is empowered to choose one. Until the government does, insurers say they are hampered in devising what kind of insurance policies to offer…
Other insurance regulations are also expected. The government has to clarify new standards for companies that insure their own workers, including what level of coverage is sufficient, how a new tax on premiums included in the health law will be assessed and how wellness programs designed to encourage employees to adopt health behaviors will operate.
