High Risk Pools/Pre-Existing Condition Insurance Program (PCIP)

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "High Risk Pools/Pre-Existing Condition Insurance Program (PCIP)"

Transcription

1 High Risk Pools/Pre-Existing Condition Insurance Program (PCIP) Summary: Provides $5 billion in immediate federal support for a new program to provide affordable coverage to uninsured Americans with pre existing conditions to help assure coverage until the new Exchanges are operational. Status update: On August 3, 2010, Vermont asked the Department of Health and Human Services (HHS) to run its high risk pool program. On August 19, 2010, Kaiser Health News notes that [a]bout 3,600 people have applied and about 1,200 have been approved so far in state plans that started in the beginning of July, with another 2,400 in plans operated by HHS. The number of enrollees is lower than many expected. On August 20, 2010 President Obama submitted a letter to Congress, requesting an additional $55 M for the high risk pool program. Next steps: June 21, 2010 High risk pools must be established by June 21, 2010 and exist until January 1, The Secretary is required to develop procedures to provide for the transition of eligible individuals enrolled in health insurance coverage offered through a high risk pool into qualified health plans offered through an Exchange, which may involve extending the January 1, 2014 deadline. July 1, 2010 The Secretary of Health and Human Services (HHS) announced a new Preexisting Condition Insurance Plan (PCIP). HHS will run the plan (as part of the Federal program) in the following 21 states: Alabama, Arizona, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Kentucky, Louisiana, Massachusetts, Minnesota, Mississippi, Nebraska, Nevada, North Dakota, South Carolina, Tennessee, Texas, Virginia, and Wyoming. (Note: On August 3, 2010, Vermont also asked HHS to run its program.) July 30, 2010 HHS issues an interim final rule regarding the PCIP, effective July 30, 2010 July 30, 2010 Effective date of the IFR August 1, 2010 PCIP coverage begins for the Federal program, if an individual has appropriately applied by July 15, August 3, 2010 Vermont asks HHS to run its program August 19, 2010 Kaiser Health News provides initial numbers for the program about 3600 applications and 1200 approved applications from the States, with another 2400 individuals enrolled in plans operated by HHS August 20, 2010 President Obama submitted a letter to Congress, requesting more funds for the high risk pool program. September 28, 2010 Comments due on the IFR

2 Additional information: President Obama s August 20 budget request letter ment_08_20_10_0.pdf Kaiser Health News August 19 article risk pools healthinsurance.aspx?utm_source=feedburner&utm_medium=feed&utm_campaign=feed%3a+kh n+%28all+kaiser+health+news%29&utm_content=google+reader July 30, 2010 interim final rule htm Healthcare.gov information regarding the Pre Existing Condition Insurance Plan (PCIP) July 1 HHS press release HHS pamphlet on the PCIP Where consumers can go to find additional information about health care options in their state HHS Fact sheet on high risk pools April 2 HHS letter to Governors Overview of state high risk pools (Kaiser Family Foundation ) Issues for structuring high risk pools (Kaiser Family Foundation issue brief) Study examining the shortage of funds for the high risk pools program ( RiskPools.pdf) CBO letter regarding the impact of high risk pools 21 High Risk_Insurance_Pools.pdf Sen. Enzi s press release regarding the lack of funding for the program ecord_id=61b099d6 802a 23ad 460c 2d32fe0e227d&Region_id=&Issue_id= Congressional Research Service (CRS) report regarding the application of various abortion provisions to high risk pools df Sen. Enzi s letter (signed by 9 other Republicans) to Secretary Sebelius regarding the application of various abortion provision to high risk pools ortion%20final%20doc2.pdf Long summary: Sec Immediate access to insurance for uninsured individuals with a preexisting condition. Requires the Secretary, no later than 90 days after the date of enactment, to establish a temporary high risk pool program to provide health insurance coverage for eligible individuals from the date of establishment until January 1, Updated September 23, 2010 Page 2

3 Administration. Allows the Secretary to implement the program directly or through contracts with state or nonprofit private entities. Requires, as a precondition for a state contract, that the state agree to not reduce previous spending levels on the operation of high risk pools. Rules for the high risk pool. Establishes a series of rules for an eligible pool, including no preexisting condition restrictions, rules related to affordability of the premiums and cost sharing, and rating requirements. Eligible individual. Deems an individual to be eligible if he or she is a citizen or national or lawfully present; has not been covered under creditable coverage (as defined in 2701(c)(1) of the PHS Act (Health Insurance Portability and Accountability Act (HIPAA) provisions) as in effect on the date of enactment during the 6 month period prior to the date on which the individual is applying for coverage through the high risk pool; and has a pre existing condition, as determined in a manner consistent with guidance issued by the Secretary. Anti dumping restrictions. Adds specific restrictions to ensure that insurers and employers do not dump employees for the pool. Funding. Provides $5 B, without any fiscal year limitation. Also provides the Secretary to adjust payments if there are insufficient funds for the high risk pool expenses. Termination. Terminates the program as of January 1, 2014, with a provision to allow the Secretary to extend the program if it is necessary to avoid a lapse in coverage between individuals covered by the high risk pool and the new Exchanges. Summary of the Regulations: Definition of pre existing condition. The program will use the definition of pre existing condition currently used in the group market under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and further specifying that pre existing condition exclusion has the same meaning as under 45 CFR That is, the term refers to a denial of coverage, or limitation or exclusion of benefits, based on the fact that the individual denied coverage or benefits had a health condition that was present before the date of enrollment for the coverage (or a denial of enrollment), whether or not any medical advice, diagnosis, care, or treatment was recommended or received before that date. This would include exclusions stemming from a condition identified via a pre enrollment questionnaire or physical examination, or the review of medical records during the pre enrollment period. Waiting period. Pre existing Condition Insurance Plan (PCIP) also cannot impose any type of coverage waiting period upon eligible individuals. For purposes of this rule, a waiting period is defined as the period immediately following the effective date of enrollment in which some or all benefits in the coverage are not provided. Accordingly, once an individual is enrolled in a PCIP consistent with the rules set forth in subpart C, full coverage must be provided to the individual starting with the effective date of enrollment. Application to children less than 6 months old. In light of the unique circumstances presented by infants who are less than six months old, the Department will issue guidance on how the requirement that the individual not have had creditable coverage during the six month period prior to the application for the PCIP program applies to and can be satisfied by such infants. Factors to be considered in this guidance include whether coverage in the hospital under the mother's plan at Updated September 23, 2010 Page 3

4 birth counts, current practices regarding insurers' coverage of newborns, and the anti dumping rules that direct the Secretary to prevent disenrollment of individuals from existing insurance due to their health status. Verifying pre existing condition. A PCIP may determine that an individual has a pre existing condition, for purposes of PCIP eligibility, based on satisfying any one or more of the following criteria, subject to HHS approval: (1) The individual provides documented evidence that an insurer has refused, or has provided clear indication that it would refuse, to issue individual coverage on grounds related to the individual's health; (2) the individual provides documented evidence that he or she has been offered individual coverage but only with a rider that excludes coverage of benefits associated with a pre existing condition; (3) the individual provides documented evidence that he or she has a medical or health condition specified by the State and approved by the Secretary; or (4) other criteria as defined by the PCIP and approved by HHS. In the PCIP program serving States that have elected not to play a role in operating a PCIP program, only the first two criteria will be used, except with respect to individuals who are guaranteed to be issued a policy. Residence requirement. An individual must be a resident of one of the 50 States or the District of Columbia which constitutes or is within the service area of the PCIP. Eligibility does not include territories. Enrollment/Disenrollment. PCIPs must establish a process for enrolling and disenrolling individuals that is approved by HHS, with the intent that the use of established enrollment policies and procedures in place under existing State high risk pools would be appropriate, to the extent that they are consistent with the statute. PCIP must allow an individual to remain enrolled unless the individual is disenrolled under specified circumstances (i.e., the individual moves out of the service area, obtains other creditable coverage, dies, does not pay the premiums, or other special circumstances) or the PCIP program is terminated. For disenrolling an individual who does not pay premiums on a timely basis, the PCIP must provide the enrollee with sufficient notice and reasonable grace period for payment prior to any disenrollment taking effect not to exceed 61 days (the longest period currently provided for by States). The consequence of failing to pay premiums and any subsequent disenrollment is that an individual loses access to coverage and may not be able to re enroll for 6 months. Those special circumstances would include cases of fraud or intentional misrepresentation of material fact, and HHS will work with the PCIPs to establish guidance in this area. An individual who is disenrolled because he or she no longer resides in the service area of a PCIP does not have to satisfy another 6 month continuous period without creditable coverage before applying to enroll in a PCIP in the new State of residence. PCIP must also establish rules governing effective dates of enrollments and disenrollments. In particular, a PCIP program must specify the deadline for receiving an enrollment application that would take effect on the first of the following month. In general, an individual who submits a complete enrollment request by an eligible individual by the 15th day of a month could access coverage by the 1st day of the following month. Exceptions to this policy will be subject to approval by HHS. Updated September 23, 2010 Page 4

5 Additional flexibility. Given the capped appropriation for this program, PCIPs need sufficient programmatic flexibility to manage their costs and enrollment, to help ensure that the PCIP program's funding allocation is sufficient to cover claims and other program costs for the entire duration of the program. Thus, a PCIP program may employ strategies to manage enrollment over the course of the program that may include enrollment capacity limits, phased in (delayed) enrollment, premium and benefit adjustments that indirectly affect enrollment, and other measures, as defined by the PCIP and approved by HHS. Required benefits. The list is consistent with the most commonly covered services offered in existing State high risk pools, according to a survey conducted by the National Association of State Comprehensive Health Insurance Plans (NASCHIP) in Its benefits are also parallel to the benefits offered by the Federal Employees Health Benefits Plan (FEHBP). Excluded services. This list of excluded services parallels that of FEHBP. The services covered by the PCIP program shall not include abortion services except in the case of rape or incest, or where the life of the woman would be endangered. Insurance rates. PCIP must not offer enrollees premiums at a rate that exceeds 100 percent of the standard individual market rate in the PCIP service area. This interim final rule does not mandate a specific formula for calculating the standard rate, but any methodology must be approved by the Secretary. Premiums charged in the PCIP can vary by age on a factor of not greater than 4 to 1. Gender rating is prohibited in the PCIP program, and rating must be based on a finite number of factors outlined in section Out of pocket costs. Out of pocket costs are defined as the sum of the annual deductible and the other annual out of pocket expenses, other than for premiums, required to be paid under the plan. The out of pocket limit may be applied only for in network providers, consistent with the terms of PCIP plan benefit package. Network providers and emergency room coverage. PCIP may specify the network of providers from whom enrollees may obtain services, provided that the PCIP demonstrates to HHS that it has a sufficient number and range of providers to ensure that all covered services are reasonably available and accessible under such coverage. In the case of emergency room services, such services must be covered out of network and out of area if (1) the enrollee had a reasonable concern that failure to obtain immediate treatment could present a serious risk to his or her life or health; and (2) the services were required to assess whether a condition requiring immediate treatment exists, or to provide such immediate treatment where warranted. Appeals procedures. PCIP must provide for a timely redetermination of an eligibility or coverage determination; coverage determinations include both whether an item or service is covered and the amount paid by the PCIP. For coverage determinations, an enrollee has the right to a timely second level appeal, or ``reconsideration,'' by an independent entity. Anti dumping provisions. PCIPs must establish procedures to identify and report to HHS instances where health insurance issuers or group health plans are discouraging high risk individuals from remaining enrolled in their current coverage, in instances where such individuals subsequently are eligible to enroll in the PCIP. Cap on administrative expenses. PCIPs can spend no more than 10 percent of its total allotted funds towards administrative expenses. Typical examples of the types of administrative costs and Updated September 23, 2010 Page 5

6 expenses include: Start up and program implementation activities, the production and distribution of information and outreach materials, eligibility determination and enrollment processing, claims processing, costs associated with prevention and detection of fraud, waste and abuse, and other ancillary services such as operation of a customer service call center, account maintenance, and appeals. Given the start up costs for the new PCIPs, and the need for expeditious implementation, this 10 percent cap applies to the total allotment for the duration of the program, as opposed to spending in a given year. PCIP funding. PCIP funding allocations are based on a blended formula based on the State population, number of uninsured individuals under 65, and geographic health care costs, in which half of the allocation is based on the number of the nonelderly population in each State, compared to the total U.S. nonelderly population. The health care cost index that HHS will use to adjust the funding allocations will be based on the wages of employees in the health services industry, and is consistent with the Children's Health Insurance Program. Over time, spending under the PCIP program will be determined based on the actual enrollment and cost experience of the PCIPs across the country, which means that HHS may propose appropriate reallocations of funds. State maintenance of effort. States must submit a process, which must be approved by the Secretary of HHS, to ensure that they are maintaining their current effort, which may include maintaining either the total amount or the total per capita amount of State funding for the operation of an existing high risk pool, maintaining the same formula for providing funding for a State high risk pool, or establishing an altered formula that the Secretary determines will not reduce the total funds expended on the existing high risk pool. Termination of program. Enrollee coverage under the PCIP program will end effective January 1, 2014 and coverage of claims under the PCIP program will extend only to the costs of covered services provided up through December 31, Legislative text: SEC IMMEDIATE ACCESS TO INSURANCE FOR UNINSURED INDIVIDUALS WITH A PREEXISTING CONDITION. (a) IN GENERAL. Not later than 90 days after the date of enactment of this Act, the Secretary shall establish a temporary high risk health insurance pool program to provide health insurance coverage for eligible individuals during the period beginning on the date on which such program is established and ending on January 1, (b) ADMINISTRATION. (1) IN GENERAL. The Secretary may carry out the program under this section directly or through contracts to eligible entities. (2) ELIGIBLE ENTITIES. To be eligible for a contract under paragraph (1), an entity shall (A) be a State or nonprofit private entity; (B) submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require; and (C) agree to utilize contract funding to establish and administer a qualified high risk pool for eligible individuals. (3) MAINTENANCE OF EFFORT. To be eligible to enter into a contract with the Secretary under this subsection, a State shall agree not to reduce the annual amount the State expended for the operation of one or more State high risk pools during the year preceding the year in which such contract is entered into. (c) QUALIFIED HIGH RISK POOL. (1) IN GENERAL. Amounts made available under this section shall be used to establish a qualified high risk pool that meets the requirements of paragraph (2). (2) REQUIREMENTS. A qualified high risk pool meets the requirements of this paragraph if such pool (A) provides to all eligible individuals health insurance coverage that does not impose any preexisting condition exclusion with respect to such coverage; (B) provides health insurance coverage (i) in which the issuer s share of the total allowed costs of benefits provided under such coverage is not less than 65 percent of such costs; and (ii) that has an out of pocket limit not greater than the applicable amount described in section 223(c)(2) of the Internal Revenue Code of 1986 for the year involved, except that the Secretary may modify such limit if necessary to ensure the pool meets the actuarial value limit under clause (i); Updated September 23, 2010 Page 6

7 (C) ensures that with respect to the premium rate charged for health insurance coverage offered to eligible individuals through the high risk pool, such rate shall (i) except as provided in clause (ii), vary only as provided for under section 2701 of the Public Health Service Act (as amended by this Act and notwithstanding the date on which such amendments take effect); (ii) vary on the basis of age by a factor of not greater than 4 to 1; and (iii) be established at a standard rate for a standard population; and (D) meets any other requirements determined appropriate by the Secretary. (d) ELIGIBLE INDIVIDUAL. An individual shall be deemed to be an eligible individual for purposes of this section if such individual (1) is a citizen or national of the United States or is lawfully present in the United States (as determined in accordance with section 1411); (2) has not been covered under creditable coverage (as defined in section 2701(c)(1) of the Public Health Service Act as in effect on the date of enactment of this Act) during the 6 month period prior to the date on which such individual is applying for coverage through the high risk pool; and (3) has a pre existing condition, as determined in a manner consistent with guidance issued by the Secretary. (e) PROTECTION AGAINST DUMPING RISK BY INSURERS. (1) IN GENERAL. The Secretary shall establish criteria for determining whether health insurance issuers and employmentbased health plans have discouraged an individual from remaining enrolled in prior coverage based on that individual s health status. (2) SANCTIONS. An issuer or employment based health plan shall be responsible for reimbursing the program under this section for the medical expenses incurred by the program for an individual who, based on criteria established by the Secretary, the Secretary finds was encouraged by the issuer to disenroll from health benefits coverage prior to enrolling in coverage through the program. The criteria shall include at least the following circumstances: (A) In the case of prior coverage obtained through an employer, the provision by the employer, group health plan, or the issuer of money or other financial consideration for disenrolling from the coverage. (B) In the case of prior coverage obtained directly from an issuer or under an employment based health plan (i) the provision by the issuer or plan of money or other financial consideration for disenrolling from the coverage; or (ii) in the case of an individual whose premium for the prior coverage exceeded the premium required by the program (adjusted based on the age factors applied to the prior coverage) (I) the prior coverage is a policy that is no longer being actively marketed (as defined by the Secretary) by the issuer; or (II) the prior coverage is a policy for which duration of coverage form issue or health status are factors that can be considered in determining premiums at renewal. (3) CONSTRUCTION. Nothing in this subsection shall be construed as constituting exclusive remedies for violations of criteria established under paragraph (1) or as preventing States from applying or enforcing such paragraph or other provisions under law with respect to health insurance issuers. (f) OVERSIGHT. The Secretary shall establish (1) an appeals process to enable individuals to appeal a determination under this section; and (2) procedures to protect against waste, fraud, and abuse. (g) FUNDING; TERMINATION OF AUTHORITY. (1) IN GENERAL. There is appropriated to the Secretary, out of any moneys in the Treasury not otherwise appropriated, $5,000,000,000 to pay claims against (and the administrative costs of) the high risk pool under this section that are in excess of the amount of premiums collected from eligible individuals enrolled in the high risk pool. Such funds shall be available without fiscal year limitation. (2) INSUFFICIENT FUNDS. If the Secretary estimates for any fiscal year that the aggregate amounts available for the payment of the expenses of the high risk pool will be less than the actual amount of such expenses, the Secretary shall make such adjustments as are necessary to eliminate such deficit. (3) TERMINATION OF AUTHORITY. (A) IN GENERAL. Except as provided in subparagraph (B), coverage of eligible individuals under a high risk pool in a State shall terminate on January 1, (B) TRANSITION TO EXCHANGE. The Secretary shall develop procedures to provide for the transition of eligible individuals enrolled in health insurance coverage offered through a high risk pool established under this section into qualified health plans offered through an Exchange. Such procedures shall ensure that there is no lapse in coverage with respect to the individual and may extend coverage after the termination of the risk pool involved, if the Secretary determines necessary to avoid such a lapse. (4) LIMITATIONS. The Secretary has the authority to stop taking applications for participation in the program under this section to comply with the funding limitation provided for in paragraph (1). (5) RELATION TO STATE LAWS. The standards established under this section shall supersede any State law or regulation (other than State licensing laws or State laws relating to plan solvency) with respect to qualified high risk pools which are established in accordance with this section. Updated September 23, 2010 Page 7

Pre-existing condition coverage post-health reform

Pre-existing condition coverage post-health reform Pre-existing condition coverage post-health reform Country: USA Partner Institute: Johns Hopkins Bloomberg School of Public Health, Department of Health Policy and Management Survey no: (16)2010 Author(s):

More information

Michael. y Health Insurance Policies

Michael. y Health Insurance Policies United States Senate Committee on Health, Education, Labor and Pensions Michael B. Enzi, Ranking Member RANKING MEMBER REPORT: Health Care Reform Law s Impact on Child-Only y Health Insurance Policies

More information

High Risk Health Pools and Plans by State

High Risk Health Pools and Plans by State High Risk Health Pools and Plans by State State Program Contact Alabama Alabama Health 1-866-833-3375 Insurance Plan 1-334-263-8311 http://www.alseib.org/healthinsurance/ahip/ Alaska Alaska Comprehensive

More information

A PUBLICATION OF THE NATIONAL COUNCIL FOR ADOPTION. HEALTH INSURANCE FOR ADOPTED CHILDREN by Mark McDermott, J.D. with Elisa Rosman, Ph.D.

A PUBLICATION OF THE NATIONAL COUNCIL FOR ADOPTION. HEALTH INSURANCE FOR ADOPTED CHILDREN by Mark McDermott, J.D. with Elisa Rosman, Ph.D. Adoption Advocate NICOLE FICERE CALLAHAN, EDITOR CHUCK JOHNSON, EDITOR NO. 19 DECEMBER 2009 A PUBLICATION OF THE NATIONAL COUNCIL FOR ADOPTION HEALTH INSURANCE FOR ADOPTED CHILDREN by Mark McDermott, J.D.

More information

Primer: The Small Business Health Options Program (SHOP) Angela Boothe October 21, 2014

Primer: The Small Business Health Options Program (SHOP) Angela Boothe October 21, 2014 Primer: The Small Business Health Options Program (SHOP) Angela Boothe October 21, 2014 Introduction On November 15th, 2014 healthcare.gov established by the Affordable Care Act (ACA) will launch an online

More information

Patient Protection and Affordable Care Act of 2009: Health Insurance Exchanges

Patient Protection and Affordable Care Act of 2009: Health Insurance Exchanges Patient Protection and Affordable Care Act of 2009: Health Insurance Exchanges Provision Notes Standards SUBTITLE D AVAILABLE COVERAGE CHOICES FOR ALL AMERICANS PART I Establishment of Qualified Health

More information

Private Health Insurance: Changes Made by the Reconciliation Act of 2010 to Senate-Passed H.R. 3590

Private Health Insurance: Changes Made by the Reconciliation Act of 2010 to Senate-Passed H.R. 3590 Private Health Insurance: Changes Made by the Reconciliation Act of 2010 to Senate-Passed H.R. 3590 Hinda Chaikind Specialist in Health Care Financing Bernadette Fernandez Analyst in Health Care Financing

More information

SECTION 109 HOST STATE LOAN-TO-DEPOSIT RATIOS. The Board of Governors of the Federal Reserve System (Board), the Federal Deposit

SECTION 109 HOST STATE LOAN-TO-DEPOSIT RATIOS. The Board of Governors of the Federal Reserve System (Board), the Federal Deposit SECTION 109 HOST STATE LOAN-TO-DEPOSIT RATIOS The Board of Governors of the Federal Reserve System (Board), the Federal Deposit Insurance Corporation (FDIC), and the Office of the Comptroller of the Currency

More information

CHAPTER 45-06-06.1 REGULATION TO IMPLEMENT THE SMALL EMPLOYER HEALTH INSURANCE AVAILABILITY ACT. 45-06-06.1-01. Definitions. As used in this chapter:

CHAPTER 45-06-06.1 REGULATION TO IMPLEMENT THE SMALL EMPLOYER HEALTH INSURANCE AVAILABILITY ACT. 45-06-06.1-01. Definitions. As used in this chapter: CHAPTER 45-06-06.1 REGULATION TO IMPLEMENT THE SMALL EMPLOYER HEALTH INSURANCE AVAILABILITY ACT Section 45-06-06.1-01 Definitions 45-06-06.1-02 Applicability and Scope 45-06-06.1-03 Establishment of Classes

More information

SECTION 109 HOST STATE LOAN-TO-DEPOSIT RATIOS. or branches outside of its home state primarily for the purpose of deposit production.

SECTION 109 HOST STATE LOAN-TO-DEPOSIT RATIOS. or branches outside of its home state primarily for the purpose of deposit production. SECTION 109 HOST STATE LOAN-TO-DEPOSIT RATIOS The Board of Governors of the Federal Reserve System, the Federal Deposit Insurance Corporation, and the Office of the Comptroller of the Currency (the agencies)

More information

EXECUTIVE OFFICE OF THE PRESIDENT. The Burden of Health Insurance Premium Increases on American Families

EXECUTIVE OFFICE OF THE PRESIDENT. The Burden of Health Insurance Premium Increases on American Families EXECUTIVE OFFICE OF THE PRESIDENT The Burden of Health Insurance Premium Increases on American Families SEPTEMBER 22, 2009 Health insurance premiums for American families continue to skyrocket. A report

More information

Supreme Court Strikes Down DOMA, Clears Way for Same-Sex Marriage in California

Supreme Court Strikes Down DOMA, Clears Way for Same-Sex Marriage in California Legislative Brief Supreme Court Strikes Down DOMA, Clears Way for Same-Sex Marriage in California On June 26, 2013, the U.S. Supreme Court announced decisions in two significant cases regarding laws affecting

More information

Health Insurance: State High Risk Pools

Health Insurance: State High Risk Pools Bernadette Fernandez Specialist in Health Care Financing January 26, 2011 Congressional Research Service CRS Report for Congress Prepared for Members and Committees of Congress 7-5700 www.crs.gov RL31745

More information

GAO PRIVATE HEALTH INSURANCE. State Oversight of Premium Rates. Report to Congressional Requesters. United States Government Accountability Office

GAO PRIVATE HEALTH INSURANCE. State Oversight of Premium Rates. Report to Congressional Requesters. United States Government Accountability Office GAO United States Government Accountability Office Report to Congressional Requesters July 2011 PRIVATE HEALTH INSURANCE State Oversight of Premium Rates GAO-11-701 July 2011 PRIVATE HEALTH INSURANCE State

More information

Summary of State Reserve Fund Laws

Summary of State Reserve Fund Laws Summary of State Reserve Fund Laws (As of July 2012) Many states have enacted legislation dealing with community association reserve and operating funds to protect owners from fiscal problems and financial

More information

IC 27-8-15 Chapter 15. Small Employer Group Health Insurance

IC 27-8-15 Chapter 15. Small Employer Group Health Insurance IC 27-8-15 Chapter 15. Small Employer Group Health Insurance IC 27-8-15-0.1 Application of certain amendments to chapter Sec. 0.1. The following amendments to this chapter apply as follows: (1) The addition

More information

The New and Temporary Federal High-Risk Insurance Pool

The New and Temporary Federal High-Risk Insurance Pool The New and Temporary Federal High-Risk Insurance Pool By Craig A. Conway, J.D., LL.M. (Health Law) caconway@central.uh.edu The Patient Protection and Affordable Care Act (PPACA), 1 includes several measures

More information

,2 2 2009 MAY. oß.vi.. Daniel R. Levinson ~ ~ .~~.vi...

,2 2 2009 MAY. oß.vi.. Daniel R. Levinson ~ ~ .~~.vi... (?.,,,-l'''4,,"vicø -r..'..ll'..410 DEPARTMENT OF HEALTH &. HUMAN SERVICES Office of Inspector General Washington, D.C. 20201 MAY,2 2 2009 TO: James Scanlon Acting Assistant Secretary for Planning Planing

More information

The Reformed New World of Health Insurance Exchanges. Arthur Lerner Barbara Ryland

The Reformed New World of Health Insurance Exchanges. Arthur Lerner Barbara Ryland The Reformed New World of Health Insurance Exchanges Arthur Lerner Barbara Ryland Introduction State Insurance Exchanges are a key component of the health reform legislation What are the Exchanges? What

More information

PROPOSED AMENDMENTS TO HOUSE BILL 2240

PROPOSED AMENDMENTS TO HOUSE BILL 2240 HB 0- (LC ) // (LHF/ps) PROPOSED AMENDMENTS TO HOUSE BILL 0 1 1 0 1 On page 1 of the printed bill, line, after ORS delete the rest of the line and delete lines through and insert.,.00,.0,.0,.01,.01,.1,.,.,.,.,

More information

Medicare Advantage Cuts in the Affordable Care Act: March 2013 Update Robert A. Book l March 2013

Medicare Advantage Cuts in the Affordable Care Act: March 2013 Update Robert A. Book l March 2013 Medicare Advantage Cuts in the Affordable Care Act: March 2013 Update Robert A. Book l March 2013 The Centers for Medicare and Medicaid Services (CMS) recently announced proposed rules that would cut payments

More information

NON-RESIDENT INDEPENDENT, PUBLIC, AND COMPANY ADJUSTER LICENSING CHECKLIST

NON-RESIDENT INDEPENDENT, PUBLIC, AND COMPANY ADJUSTER LICENSING CHECKLIST NON-RESIDENT INDEPENDENT, PUBLIC, AND COMPANY ADJUSTER LICENSING CHECKLIST ** Utilize this list to determine whether or not a non-resident applicant may waive the Oklahoma examination or become licensed

More information

State-Specific Annuity Suitability Requirements

State-Specific Annuity Suitability Requirements Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Effective 10/16/11: Producers holding a life line of authority on or before 10/16/11 who sell or wish to sell

More information

United States Government Accountability Office March 2011 GAO-11-268

United States Government Accountability Office   March 2011 GAO-11-268 GAO United States Government Accountability Office Report to the Secretary of Health and Human Services and the Secretary of Labor March 2011 PRIVATE HEALTH INSURANCE Data on Application and Coverage Denials

More information

Supreme Court Strikes Down DOMA, Clears Way for Same-Sex Marriage in California

Supreme Court Strikes Down DOMA, Clears Way for Same-Sex Marriage in California Brought to you by Alamo Insurance Group Supreme Court Strikes Down DOMA, Clears Way for Same-Sex On June 26, 2013, the U.S. Supreme Court announced decisions in two significant cases regarding laws affecting

More information

Understanding the Affordable Care Act

Understanding the Affordable Care Act Understanding the Affordable Care Act The Affordable Care Act (officially called the Patient Protection and Affordable Care Act) is the law that mandates that everyone in the United States maintain health

More information

The Health Insurance Marketplace 101

The Health Insurance Marketplace 101 The Health Insurance Marketplace 101 National Newspaper Association 127th Annual Convention & Trade Show September 13, 2013 Office of the Regional Director Community Resource California-Based Arizona,

More information

Christy Tinnes, Brigen Winters and Christine Keller, Groom Law Group, Chartered

Christy Tinnes, Brigen Winters and Christine Keller, Groom Law Group, Chartered Preparing for Health Care Reform A Chronological Guide for Employers This Article provides an overview of the major provisions of health care reform legislation affecting employers and explains the requirements

More information

Cancellation of Nongroup Health Insurance Policies

Cancellation of Nongroup Health Insurance Policies Cancellation of Nongroup Health Insurance Policies Bernadette Fernandez Specialist in Health Care Financing Annie L. Mach Analyst in Health Care Financing November 19, 2013 Congressional Research Service

More information

14-Sep-15 State and Local Tax Deduction by State, Tax Year 2013

14-Sep-15 State and Local Tax Deduction by State, Tax Year 2013 14-Sep-15 State and Local Tax Deduction by State, Tax Year 2013 (millions) deduction in state dollars) claimed (dollars) taxes paid [1] state AGI United States 44.2 100.0 30.2 507.7 100.0 11,483 100.0

More information

Update: Health Insurance Reforms and Rate Review. Health Insurance Reform Requirements for the Group and Individual Insurance Markets

Update: Health Insurance Reforms and Rate Review. Health Insurance Reform Requirements for the Group and Individual Insurance Markets By Katherine Jett Hayes and Taylor Burke Background Update: Health Insurance Reforms and Rate Review The Patient Protection and Affordable Care Act (ACA) included health insurance market reforms designed

More information

Managing Health Care Reform Benefit Changes within your Own Organization

Managing Health Care Reform Benefit Changes within your Own Organization ICCMHC Winter Conference February 17, 2011 Managing Health Care Reform Benefit Changes within your Own Organization John F. Gause, President jgause@apexbg.com Overview Health Care Reform - Short Term Impact

More information

EMBARGOED UNTIL 6:00 AM ET WEDNESDAY, NOVEMBER 30, 2011

EMBARGOED UNTIL 6:00 AM ET WEDNESDAY, NOVEMBER 30, 2011 A State-by-State Look at the President s Payroll Tax Cuts for Middle-Class Families An Analysis by the U.S. Department of the Treasury s Office of Tax Policy The President signed into law a 2 percentage

More information

Impacts of Sequestration on the States

Impacts of Sequestration on the States Impacts of Sequestration on the States Alabama Alabama will lose about $230,000 in Justice Assistance Grants that support law STOP Violence Against Women Program: Alabama could lose up to $102,000 in funds

More information

ADDENDUM TO THE HEALTH INSURANCE MARKETPLACE SUMMARY ENROLLMENT REPORT FOR THE INITIAL ANNUAL OPEN ENROLLMENT PERIOD

ADDENDUM TO THE HEALTH INSURANCE MARKETPLACE SUMMARY ENROLLMENT REPORT FOR THE INITIAL ANNUAL OPEN ENROLLMENT PERIOD ASPE Issue BRIEF ADDENDUM TO THE HEALTH INSURANCE MARKETPLACE SUMMARY ENROLLMENT REPORT FOR THE INITIAL ANNUAL OPEN ENROLLMENT PERIOD For the period: October 1, 2013 March 31, 2014 (Including Additional

More information

Low-Profit Limited Liability Company (L3C) Date: July 29, 2013. [Low-Profit Limited Liability Company (L3C)] [July 29, 2013]

Low-Profit Limited Liability Company (L3C) Date: July 29, 2013. [Low-Profit Limited Liability Company (L3C)] [July 29, 2013] Topic: Question by: : Low-Profit Limited Liability Company (L3C) Kevin Rayburn, Esq., MBA Tennessee Date: July 29, 2013 Manitoba Corporations Canada Alabama Alaska Arizona Arkansas California Colorado

More information

Health Reform. Health Insurance Market Reforms: Pre-Existing Condition Exclusions

Health Reform. Health Insurance Market Reforms: Pre-Existing Condition Exclusions Health Insurance Market Reforms: Pre-Existing Cditi Exclusis SEPTEMBER 2012 Overview What is a pre-existing cditi? Pre-existing cditis are medical cditis or other health problems that existed before the

More information

July 23, 2013. The Honorable Orrin G. Hatch Ranking Member Committee on Finance United States Senate

July 23, 2013. The Honorable Orrin G. Hatch Ranking Member Committee on Finance United States Senate 441 G St. N.W. Washington, DC 20548 July 23, 2013 The Honorable Orrin G. Hatch Ranking Member Committee on Finance United States Senate Subject: Private Health Insurance: The Range of Base Premiums in

More information

Workers Compensation Small Medical-Only Claims: Should an employer pay them or turn them in to the insurance company?

Workers Compensation Small Medical-Only Claims: Should an employer pay them or turn them in to the insurance company? Workers Compensation Small Medical-Only Claims: Should an employer pay them or turn them in to the insurance company? by Maureen Gallagher The most common question an insurance agent gets from employers

More information

SMALL BUSINESS HEALTH INSURANCE EXCHANGES. Low Initial Enrollment Likely due to Multiple, Evolving Factors

SMALL BUSINESS HEALTH INSURANCE EXCHANGES. Low Initial Enrollment Likely due to Multiple, Evolving Factors United States Government Accountability Office Report to the Chairman, Committee on Small Business, House of Representatives November 2014 SMALL BUSINESS HEALTH INSURANCE EXCHANGES Low Initial Enrollment

More information

Frequently Asked Questions The State Children s Health Insurance Program

Frequently Asked Questions The State Children s Health Insurance Program NATIONAL CONFERENCE of STATE LEGISLATURES FORUM for STATE HEALTH POLICY LEADERSHIP Frequently Asked Questions The State Children s Health Insurance Program In this FAQ What is SCHIP? How is SCHIP different

More information

Health Care Policy Cost Index 2012: Ranking the States According to Policies Affecting the Cost of Health Coverage

Health Care Policy Cost Index 2012: Ranking the States According to Policies Affecting the Cost of Health Coverage Health Care Policy Cost Index 2012: Ranking the States According to Policies Affecting the Cost of Health Coverage by Raymond J. Keating Chief Economist Small Business & Entrepreneurship Council February

More information

InSight. A Littler Mendelson Report. Health Care Reform: Are You Prepared? A Timeline for Employers to Follow

InSight. A Littler Mendelson Report. Health Care Reform: Are You Prepared? A Timeline for Employers to Follow A Littler Mendelson Report InSight An Analysis of Recent Developments & Trends In This Issue: April 2010 The Patient Protection and Affordable Care Act was signed into law on March 23, 2010. Amendments

More information

Affordable Care Act (ACA) Frequently Asked Questions

Affordable Care Act (ACA) Frequently Asked Questions Grandfathered policies Q1: What is grandfathered health plan coverage? A: The interim final rule on grandfathering under ACA generally defines grandfathered health plan coverage as coverage provided by

More information

Three-Year Moving Averages by States % Home Internet Access

Three-Year Moving Averages by States % Home Internet Access Three-Year Moving Averages by States % Home Internet Access Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana

More information

Medicaid Topics Impact of Medicare Dual Eligibles Stephen Wilhide, Consultant

Medicaid Topics Impact of Medicare Dual Eligibles Stephen Wilhide, Consultant Medicaid Topics Impact of Medicare Dual Eligibles Stephen Wilhide, Consultant Issue Summary The term dual eligible refers to the almost 7.5 milion low-income older individuals or younger persons with disabilities

More information

List of State DMV Websites

List of State DMV Websites List of State DMV Websites Alabama Alabama Department of Revenue Motor Vehicle Division http://www.ador.state.al.us/motorvehicle/index.html Alaska Alaska Department of Administration Division of Motor

More information

Health Insurance Exchanges and the Medicaid Expansion After the Supreme Court Decision: State Actions and Key Implementation Issues

Health Insurance Exchanges and the Medicaid Expansion After the Supreme Court Decision: State Actions and Key Implementation Issues Health Insurance Exchanges and the Medicaid Expansion After the Supreme Court Decision: State Actions and Key Implementation Issues Sara R. Collins, Ph.D. Vice President, Affordable Health Insurance The

More information

STATISTICAL BRIEF #273

STATISTICAL BRIEF #273 STATISTICAL BRIEF #273 December 29 Employer-Sponsored Health Insurance for Employees of State and Local Governments, by Census Division, 28 Beth Levin Crimmel, M.S. Introduction Employees of state and

More information

Summary of the Major Provisions in the Patient Protection and Affordable Health Care Act

Summary of the Major Provisions in the Patient Protection and Affordable Health Care Act Summary of the Major Provisions in the Patient Protection and Affordable Care Act Updated 10/22/10 On March 23, 2010, President Barack Obama signed into law comprehensive health care reform legislation,

More information

State Tax Information

State Tax Information State Tax Information The information contained in this document is not intended or written as specific legal or tax advice and may not be relied on for purposes of avoiding any state tax penalties. Neither

More information

Summary Enrollment Report, which can be accessed at http://aspe.hhs.gov/health/reports/2014/marketplaceenrollment/apr2014/ib_2014apr_enrollment.pdf.

Summary Enrollment Report, which can be accessed at http://aspe.hhs.gov/health/reports/2014/marketplaceenrollment/apr2014/ib_2014apr_enrollment.pdf. ASPE ISSUE BRIEF HEALTH INSURANCE MARKETPLACE 2015 OPEN ENROLLMENT PERIOD: JANUARY ENROLLMENT REPORT For the period: November 15, 2014 January 16, 2015 1 January 27, 2015 The Health Insurance Marketplace

More information

Public School Teacher Experience Distribution. Public School Teacher Experience Distribution

Public School Teacher Experience Distribution. Public School Teacher Experience Distribution Public School Teacher Experience Distribution Lower Quartile Median Upper Quartile Mode Alabama Percent of Teachers FY Public School Teacher Experience Distribution Lower Quartile Median Upper Quartile

More information

Health Insurance Exchanges

Health Insurance Exchanges Brought to you by Linden Group Health Services, Inc. Health Insurance Exchanges The Affordable Care Act (ACA) requires each state to have a competitive marketplace, known as an Affordable Health Insurance

More information

TITLE I QUALITY, AFFORDABLE HEALTH CARE FOR ALL AMER- ICANS Subtitle A Immediate Improvements in Health Care Coverage for All Americans

TITLE I QUALITY, AFFORDABLE HEALTH CARE FOR ALL AMER- ICANS Subtitle A Immediate Improvements in Health Care Coverage for All Americans 1 TITLE I QUALITY, AFFORDABLE HEALTH CARE FOR ALL AMER- ICANS Subtitle A Immediate Improvements in Health Care Coverage for All Americans SEC. 01. AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT. Part A of

More information

THE BURDEN OF HEALTH INSURANCE PREMIUM INCREASES ON AMERICAN FAMILIES AN UPDATE ON THE REPORT BY THE EXECUTIVE OFFICE OF THE PRESIDENT

THE BURDEN OF HEALTH INSURANCE PREMIUM INCREASES ON AMERICAN FAMILIES AN UPDATE ON THE REPORT BY THE EXECUTIVE OFFICE OF THE PRESIDENT THE BURDEN OF HEALTH INSURANCE PREMIUM INCREASES ON AMERICAN FAMILIES AN UPDATE ON THE REPORT BY THE EXECUTIVE OFFICE OF THE PRESIDENT INTRODUCTION In September 2009, the Executive Office of the President

More information

NC General Statutes - Chapter 58 Article 68 1

NC General Statutes - Chapter 58 Article 68 1 Article 68. Health Insurance Portability and Accountability. 58-68-1 through 58-68-20: Repealed by Session Laws 1997-259, s. 1(a). Part A. Group Market Reforms. Subpart 1. Portability, Access, and Renewability

More information

State Individual Income Taxes: Treatment of Select Itemized Deductions, 2006

State Individual Income Taxes: Treatment of Select Itemized Deductions, 2006 State Individual Income Taxes: Treatment of Select Itemized Deductions, 2006 State Federal Income Tax State General Sales Tax State Personal Property Tax Interest Expenses Medical Expenses Charitable Contributions

More information

Patient Protection and Affordable Care Act of 2009: Immediate Health Insurance Market Reforms

Patient Protection and Affordable Care Act of 2009: Immediate Health Insurance Market Reforms Patient Protection and Affordable Care Act of 2009: Immediate Health Insurance Market Reforms Provision Notes Standards Development Applicability Effective Date PPACA Statutory Annual and Lifetime Limits

More information

Senate-Passed Bill (Patient Protection and Affordable Care Act H.R. 3590)**

Senate-Passed Bill (Patient Protection and Affordable Care Act H.R. 3590)** Prevention and Screening Services Cost-sharing Eliminates cost sharing requirements for requirements for all preventive services (including prevention and colorectal cancer screening) that have a screening

More information

North Carolina Statutes Health Insurance Portability and Accountability PART A. GROUP MARKET REFORMS

North Carolina Statutes Health Insurance Portability and Accountability PART A. GROUP MARKET REFORMS North Carolina Statutes Health Insurance Portability and Accountability PART A. GROUP MARKET REFORMS SUBPART 1. PORTABILITY, ACCESS, AND RENEWABILITY REQUIREMENTS 58-68-25. Definitions; excepted benefits;

More information

REPORT SPECIAL. States Act to Help People Laid Off from Small Firms: More Needs to Be Done. Highlights as of April 14, 2009

REPORT SPECIAL. States Act to Help People Laid Off from Small Firms: More Needs to Be Done. Highlights as of April 14, 2009 REPORT April 2009 States Act to Help People Laid Off from Small Firms: More Needs to Be Done In the past two months, several states have taken action to make sure state residents who lose their jobs in

More information

PUBLIC LAW 104 191 AUG. 21, 1996 HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996

PUBLIC LAW 104 191 AUG. 21, 1996 HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996 HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996 110 STAT. 1936 PUBLIC LAW 104 191 AUG. 21, 1996 Aug. 21, 1996 [H.R. 3103] Health Insurance Portability and Accountability Act of 1996. 42 USC

More information

Senate Bill No. 2 CHAPTER 673

Senate Bill No. 2 CHAPTER 673 Senate Bill No. 2 CHAPTER 673 An act to amend Section 6254 of the Government Code, to add Article 3.11 (commencing with Section 1357.20) to Chapter 2.2 of Division 2 of the Health and Safety Code, to add

More information

CHAPTER 7. (Senate Bill 6) Working Families and Small Business Health Coverage Act

CHAPTER 7. (Senate Bill 6) Working Families and Small Business Health Coverage Act CHAPTER 7 (Senate Bill 6) AN ACT concerning Working Families and Small Business Health Coverage Act FOR the purpose of establishing a Small Employer Health Insurance Benefit Plan Premium Subsidy Program;

More information

Young Adults and the Affordable Care Act: Protecting Young Adults and Eliminating Burdens on Families and Businesses

Young Adults and the Affordable Care Act: Protecting Young Adults and Eliminating Burdens on Families and Businesses Young Adults and the Affordable Care Act: Protecting Young Adults and Eliminating Burdens on Families and Businesses The Affordable Care Act allows young adults to stay on their parents health care plan

More information

States and HIPAA information

States and HIPAA information States and HIPAA information Prepared by: Jennifer Bible, MSW Alabama: Alabama s Medicaid website contains HIPAA information at http://www.medicaid.alabama.gov/resources/hipaa.aspx?tab=5. Extensive FAQ

More information

Health Reform and the AAP: What the New Law Means for Children and Pediatricians

Health Reform and the AAP: What the New Law Means for Children and Pediatricians Health Reform and the AAP: What the New Law Means for Children and Pediatricians Throughout the health reform process, the American Academy of Pediatrics has focused on three fundamental priorities for

More information

CONTRACT TO OPERATE A QUALIFIED HIGH RISK POOL

CONTRACT TO OPERATE A QUALIFIED HIGH RISK POOL CONTRACT TO OPERATE A QUALIFIED HIGH RISK POOL CONTRACT AGREEMENT: Between the Department of Health and Human Services (HHS) and Arkansas Comprehensive Health Insurance Pool PROJECT TITLE: Temporary High

More information

PROGRAM MEMORANDUM INSURANCE COMMISSIONERS INSURANCE ISSUERS

PROGRAM MEMORANDUM INSURANCE COMMISSIONERS INSURANCE ISSUERS PROGRAM MEMORANDUM INSURANCE COMMISSIONERS INSURANCE ISSUERS Department of Health and Human Services Centers for Medicare and Medicaid Services Transmittal No. 04-01 Date March 2004 Title: Subject: Market:

More information

Legislative & Regulatory Information

Legislative & Regulatory Information Americas - U.S. Legislative, Privacy & Projects Topic Citation: UFS Jurisdiction Effective Date Author Release Date File No. Federal Multiple Joseph Tigro 3/10/14 LI-487 Affordable Care Act, Dental Patient

More information

GAO PRIVATE HEALTH INSURANCE. Estimates of Individuals with Pre-Existing Conditions Range from 36 Million to 122 Million

GAO PRIVATE HEALTH INSURANCE. Estimates of Individuals with Pre-Existing Conditions Range from 36 Million to 122 Million GAO United States Government Accountability Office Report to Congressional Requesters March 2012 PRIVATE HEALTH INSURANCE Estimates of Individuals with Pre-Existing Conditions Range from 36 Million to

More information

PUBLIC HOUSING AUTHORITY COMPENSATION

PUBLIC HOUSING AUTHORITY COMPENSATION PUBLIC HOUSING AUTHORITY COMPENSATION Background After concerns were raised about the level of compensation being paid to some public housing authority (PHA) leaders, in August 2011 HUD reached out to

More information

State Estate Taxes BECAUSE YOU ASKED ADVANCED MARKETS

State Estate Taxes BECAUSE YOU ASKED ADVANCED MARKETS ADVANCED MARKETS State Estate Taxes In 2001, President George W. Bush signed the Economic Growth and Tax Reconciliation Act (EGTRRA) into law. This legislation began a phaseout of the federal estate tax,

More information

Question by: Karon Beyer. Date: March 28, 2012. [LLC Question] [2012-03-29]

Question by: Karon Beyer. Date: March 28, 2012. [LLC Question] [2012-03-29] Topic: LLC Question Question by: Karon Beyer : Florida Date: March 28, 2012 Manitoba Corporations Canada Alabama Alaska Arizona Arkansas California Colorado Arizona uses "manager" or "member," but not

More information

HIPAA Common Questions: Administration

HIPAA Common Questions: Administration Brought to you by Momentous Insurance Brokerage, Inc. HIPAA Common Questions: Administration When were the final HIPAA Nondiscrimination Regulations effective? The final HIPAA Nondiscrimination Regulations

More information

versus versus RomneyCandidateCare A National and State-by-State Analysis Families USA

versus versus RomneyCandidateCare A National and State-by-State Analysis Families USA ObamaCare versus RomneyCare versus RomneyCandidateCare A National and State-by-State Analysis Families USA The development of this Families USA report was aided enormously by three distinguished health

More information

ACA Health Insurance Exchanges State Costs & Status

ACA Health Insurance Exchanges State Costs & Status Updated: April 22, 2013 ACA Health Insurance Exchanges State Costs & Status GRANTS RECEIVED * ANNUAL OPERATING COST ON HIX RWJF HELP # of employees HIX CHOICE Enroll UX CITATION LINKS FOR COSTS Alabama

More information

Medicare Coverage Gap Discount Program (Filling the Donut Hole)

Medicare Coverage Gap Discount Program (Filling the Donut Hole) Medicare Coverage Gap Discount Program (Filling the Donut Hole) Summary: Requires drug manufacturers to provide a 50 percent discount to Part D beneficiaries for brand name drugs and biologics purchased

More information

Arizona State Senate Issue Brief June 22, 2010 SMALL BUSINESS HEALTH INSURANCE. Overview. What is a Small Business? Note to Reader: INTRODUCTION

Arizona State Senate Issue Brief June 22, 2010 SMALL BUSINESS HEALTH INSURANCE. Overview. What is a Small Business? Note to Reader: INTRODUCTION Arizona State Senate Issue Brief June 22, 2010 Note to Reader: The Senate Research Staff provides nonpartisan, objective legislative research, policy analysis and related assistance to the members of the

More information

Marketplaces (Exchanges): Information for Employers and Individuals Lisa Klinger, J.D. www.leavitt.com/healthcarereform.com

Marketplaces (Exchanges): Information for Employers and Individuals Lisa Klinger, J.D. www.leavitt.com/healthcarereform.com 10-21- 2013 As of January 1, 2014, the Patient Protection and Affordable Care Act (PPACA) requires most U.S. citizens and lawful residents to either have minimum essential coverage or to pay a federal

More information

State Regulations Regarding Recoupments

State Regulations Regarding Recoupments STATE STATUTE/CODE TIME LIMIT FOR SEEKING REFUND OF CLAIM ALABAMA AL 27-1-17 One year from the date that the initial claim was paid. ALASKA AS 21.54.020 The insurer can recover any amount mistakenly paid

More information

Health Care Policy Cost Index 2011: Ranking the States According to Policies Affecting the Cost of Health Care

Health Care Policy Cost Index 2011: Ranking the States According to Policies Affecting the Cost of Health Care Health Care Policy Cost Index 2011: Ranking the States According to Policies Affecting the Cost of Health Care by Raymond J. Keating Chief Economist Small Business & Entrepreneurship Council 2944 Hunter

More information

Zurich Term Death Benefit Protection With Options

Zurich Term Death Benefit Protection With Options Zurich Term Death Benefit Protection With Options Offered by Zurich American Life Insurance Company Zurich Term life insurance provides death benefit protection plus a contractual right to convert to any

More information

Concise Guide to Assistance for Jobless Workers in the American Recovery and Reinvestment Act

Concise Guide to Assistance for Jobless Workers in the American Recovery and Reinvestment Act National Employment Law Project Concise Guide to Assistance for Jobless Workers in the American Recovery and Reinvestment Act Introduction Congress recently passed the American Recovery and Reinvestment

More information

Center for Medicaid and State Operations SMDL #04-004 JULY 19, 2004. Dear State Medicaid Director:

Center for Medicaid and State Operations SMDL #04-004 JULY 19, 2004. Dear State Medicaid Director: DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop S2-26-12 Baltimore, Maryland 21244-1850 Center for Medicaid and State Operations SMDL #04-004

More information

SAF s ACA Guide: The Small Business Health (SHOP) Exchanges SHOP Delays

SAF s ACA Guide: The Small Business Health (SHOP) Exchanges SHOP Delays SAF s ACA Guide: The Small Business Health (SHOP) Exchanges The premise behind the SHOP Exchange was simple. Small businesses would be able to purchase coverage in a public marketplace in the same way

More information

List of State Residual Insurance Market Entities and State Workers Compensation Funds

List of State Residual Insurance Market Entities and State Workers Compensation Funds List of State Residual Insurance Market Entities and State Workers Compensation Funds On November 26, 2002, President Bush signed into law the Terrorism Risk Insurance Act of 2002 (Public Law 107-297,

More information

Fiscal Fact. IRS Issues State of Celebration Guidance for Same-Sex Couples Further Guidance by 24 States May Be Required. By Joseph Henchman

Fiscal Fact. IRS Issues State of Celebration Guidance for Same-Sex Couples Further Guidance by 24 States May Be Required. By Joseph Henchman August 29, 2013 No. 393 Fiscal Fact IRS Issues State of Celebration Guidance for Same-Sex Couples Further Guidance by 24 States May Be Required By Joseph Henchman Executive Summary The IRS today announced

More information

Health Care Reform Frequently Asked Questions (FAQ) Consumers Employers

Health Care Reform Frequently Asked Questions (FAQ) Consumers Employers This page provides answers to frequently asked questions (FAQ) regarding The Patient Protection and Affordable Care Act (PPACA; P.L. 111-148) and the Health Care and Education Reconciliation Act of 2010

More information

Selected Employer Provisions in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010

Selected Employer Provisions in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 Selected Employer Provisions in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 This chart outlines, in depth, selected provisions in the Patient

More information

HOUSE BILL No. 2087. By Committee on Insurance 1-26. AN ACT enacting the Kansas professional employer organization licensing

HOUSE BILL No. 2087. By Committee on Insurance 1-26. AN ACT enacting the Kansas professional employer organization licensing Session of 00 HOUSE BILL No. 0 By Committee on Insurance - 0 0 AN ACT enacting the Kansas professional employer organization licensing act. Be it enacted by the Legislature of the State of Kansas: Section.

More information

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA ) ) ) ) ) ) ) ) ) ) ) ) ) ) CONSENT JUDGMENT

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA ) ) ) ) ) ) ) ) ) ) ) ) ) ) CONSENT JUDGMENT IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA UNITED STATES OF AMERICA, et al., v. Plaintiffs, HSBC NORTH AMERICA HOLDINGS INC., et al., Defendants. ) ) ) ) ) ) ) ) ) ) ) ) ) ) Civil

More information

********************

******************** THE SURETY & FIDELITY ASSOCIATION OF AMERICA 1101 Connecticut Avenue, N.W., Suite 800 Washington, D. C. 20036 Phone: (202) 463-0600 Fax: (202) 463-0606 Web page: www.surety.org APPLICATION Application

More information

$7.5 appropriation $6.5 2011 2012 2013 2014 2015 2016. Preschool Development Grants

$7.5 appropriation $6.5 2011 2012 2013 2014 2015 2016. Preschool Development Grants School Readiness: High-Quality Early Learning Head Start $10.5 $9.5 $10.1 +$1.5 +17.7% $8.5 $7.5 +$2.1 +27.0% $6.5 for fiscal year 2010 Included in the budget is $1.078 billion to ensure that every Head

More information

American C.E. Requirements

American C.E. Requirements American C.E. Requirements Alaska Board of Nursing Two of the following: 30 contact hours 30 hours of professional nursing activities 320 hours of nursing employment Arizona State Board of Nursing Arkansas

More information

Model Regulation Service January 2006 DISCLOSURE FOR SMALL FACE AMOUNT LIFE INSURANCE POLICIES MODEL ACT

Model Regulation Service January 2006 DISCLOSURE FOR SMALL FACE AMOUNT LIFE INSURANCE POLICIES MODEL ACT Table of Contents Section 1. Section 2. Section 3. Section 4. Section 5. Section 6. Section 1. Model Regulation Service January 2006 Purpose Definition Exemptions Disclosure Requirements Insurer Duties

More information

Patient Protection and Affordable Care Act (H.R. 3590)

Patient Protection and Affordable Care Act (H.R. 3590) on Health Reform Passing comprehensive health care reform has been a priority of the President and Congress. The U.S. House of Representatives passed the Affordable Health Care for America Act on November

More information

NAIC ANNUITY TRAINING Regulations By State

NAIC ANNUITY TRAINING Regulations By State Select a state below to display the current regulation and requirements, or continue to scroll down. Light grey text signifies states that have not adopted an annuity training program. Alabama Illinois

More information