CONNECTICUT health insurance : EasyToInsureME : health reform bills

CONNECTICUT health insurance : The House and Senate have passed two key health reform bills. The first is pooling legislation that would require the comptroller to offer employee and retiree coverage under the state benefit plan, to non-state public employers, municipal-related and nonprofit employers, and small employers. It would allow the pool to self-insure. In 2008, Governor M. Jodi Rell vetoed similar pooling legislation. The second measure would establish a board of directors charged with implementing the SustiNet plan, a single-payer health plan. Both bills now go to the Governor. The House also passed the amended autism mandate legislation in concurrence with the Senate. Coverage for behavioral therapy is limited to $50,000 yearly for a child who is less than nine years of age, $35,000 for a child who is at least nine and less than 13 years of age, and $25,000 for a child who is at least 13 and less than 15 years of age. The measure now goes to Governor Rell who is expected to sign it into law effective January 1, 2010. In addition, the House passed a new omnibus mandate bill that pulls together seven different mandates ranging from increased coverage of ostomy supplies to coverage for bone marrow testing. It now goes to the Senate for consideration.

CONNECTICUT health insurance : EasyToInsureME : Children

CONNECTICUT health insurance : The Senate last week passed an autism mandate bill the same day that it was made public. It would establish a three-tiered benefit for behavioral therapy services: 1) $50,000 for children under age nine, 2) $35,000 for children under 13, and 3) $25,000 for children under age 15. The bill does specify that "nothing in the section shall be construed to require group policies to provide reimbursement for special education and related services unless otherwise required by state or federal law." In addition, coverage under this mandate would be subject to other general exclusions and limitations of the policy. If enacted, the new mandate would be effective Jan. 1, 2010. The bill now goes to the House.

CONNECTICUT: The Insurance and Real Estate Committee voted to amend the "Sustinet Plan" legislation to a study bill

CONNECTICUT Health Insurance : The Insurance and Real Estate Committee voted to amend the "Sustinet Plan" legislation to a study bill. The proposal did include several positive measures to reduce costs, improve quality and help more people gain access to health insurance, but it also would have created a massive, government-run health care plan. The study amendment is oddly contradictory as it treats the government takeover as an enacted proposal, mandating its implementation even before a study is to take place. Health plans and their business partners are urging lawmakers to actually study the issue before making final decisions. In a positive development, the Insurance Committee voted to defeat the long-term disability bill that would have allowed employees on disability to collect both their private insurance benefits and Social Security disability payments. Neither long-term disability insurance nor Social Security Disability Insurance are intended to provide employees with more compensation while on disability than they would have received while at work, which is why every state currently allows the offset. Aetna worked with its plan sponsors and industry partners to raise awareness and increase understanding of the bill's unintended consequences.

CONNECTICUT Health Insurance : defeat of several medical loss ratio (MLR) bills : EasyToInsureME

CONNECTICUT Health Insurance : Action was taken on a number of health care bills this week, resulting in the defeat of several medical loss ratio (MLR) bills. Only Senate President Donald Williams' proposal requiring health plans to report their medical loss ratio in the state's "Consumer Report Card on Health Insurance" passed the Senate. It now sits on a House calendar. Legislation expanding coverage for clinical trial patients' routine patient-care costs was voted out of the Insurance and Real Estate Committee and is now with the Senate Appropriations Committee. This mandate would apply to medically necessary services for trials treating serious or life-threatening diseases. A mandate requiring coverage for wound care supplies for individuals with Epidermolysis Bullosa passed the House and now sits on a Senate calendar. Legislation prohibiting the selling, leasing, renting, assigning or granting access to provider network discounts was defeated in the Judiciary Committee. While the budget is center stage presently, health care reform and pooling legislation are likely to be front and center in May and June. Aetna is meeting with Senate leadership to continue a dialogue on health care reform tailored to Connecticut's small businesses and uninsured individuals.