Health reform could foil mini-med plans
By Editorial Staff
June 21, 2010
As industry practitioners continue to peel the onion on health care reform’s impact, a new layer of concern is now reverberating across the worksite market.
The survival of so-called mini-medical plans, most of which are offered on a voluntary basis and target part-time or seasonal employees, hangs in the balance under the Patient Protection and Affordable Care Act. At issue is a provision stipulating that health insurers cannot offer such coverage through state exchanges and ruling that the plans do not qualify as “essential benefits.”
Dave Evans, senior vice president of the Independent Insurance Agents & Brokers of America, known as the “Big I,” says the uncertain fate of mini-med policies hinges on a U.S. Department of Health and Human Services ruling on whether the new health care mandates will apply to these plans.
“There has been an appetite for these products,” he observes, “and we hope that they are not taken off the menu under the guise of health care reform.”
One industry official was quoted in a recent report as saying HHS has the “regulatory latitude to completely destroy these plans, eliminating them from the marketplace, if they choose to say that the market reforms – no annual or lifetime limits – apply to mini-med plans.”
Intensive lobbying efforts are under way to preserve such coverage, which also are known as limited-benefit health insurance plans that pay benefits for specified medical conditions.
Joel Kopperud, a director for congressional relations at the Council of Insurance Agents and Brokers (CIAB), recently met with HHS staffers to push for an exemption of the plans from an upcoming rule on annual dollar limits. Without such a ruling, he warns that nearly 1.4 million Americans could lose their coverage until 2014.
“We’re working closely with industry allies that include carriers and employers, and hope we can continue to serve as a resource for the administration as they look for ways to preserve coverage for more these Americans during the transition to state exchanges,” he reports.
CIAB, along with the Big I, National Association of Health Underwriters and National Association of Insurance and Financial Advisers, offered input on this issue – specifically, how to define the medical-loss ratio – in a comment letter to HHS.
Ternian Insurance Group LLC, whose founders helped pioneer the concept of mini-meds, recently issued an analysis of health care reform’s impact on mini-med plans and was sanguine that the company’s product offerings would remain a viable option – noting that supplemental medical products are expected to play a significant role in filling gaps created by qualified health benefit plans.
Source: Employee Benefit News article used by permission
Tags: HHS, mini-meds, worksite market