HMSA: We Won't Cancel Policies Until After the Election

KITV Nov 15, 2013: Late Friday, HMSA announced it would comply with Ito's request to continue coverage of plans that don't meet ACA requirements. That means about 12,400 individual plan members and 8,000 small business members can keep their current health policies for another year.  

"Our individual plan members who don't choose a new ACA plan by Dec. 15 will be re-enrolled in their current plan in December for another year to ensure they don't lose coverage," Elisa Yadao, HMSA senior vice president of consumer experience, said in a statement.

However, other insurance carriers are still deciding whether to comply with the insurance commissioner's request.

"We are still looking at the feasibility of executing the Insurance Commissioner's request.  Changes of this kind, this far in to the process, if not handled carefully, could cause further problems, which is the last thing anyone wants to happen," read a statement Friday from Kaiser Permanente.

UHA also weighed in late Friday, saying it's taking a wait-and-see approach.

"The health insurance environment is exceedingly complex and we are monitoring the development of new regulations on both the federal and state levels to determine the best course of action for our 52,000-plus members," Lance Kaneshiro, UHA's executive vice president and chief operating officer, said in a statement.

Meanwhile, it remains unclear what impact the insurance commissioner's request will have on the Hawaii Health Connector, the state's health insurance exchange. The Connector was counting on individuals with non-ACA-compliant health plans to participate in the exchange.

read ... After the Elections

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State Requests Insurance Carriers to Continue Non-Renewed Health Plans

News Release from DCCA November 15, 2013

HONOLULU — State Insurance Commissioner Gordon Ito is requesting that Hawaii’s insurance carriers continue health plans that faced non-renewal by the end of the year. The request follows President Barack Obama’s decision to allow states and insurers to choose which plans to continue as the federal Affordable Care Act (ACA) is implemented.

The ACA required the inclusion of 10 essential health benefits. The non-renewed plans did not meet those requirements. This new decision gives the consumer an opportunity to decide whether they want to stay with their existing plan, regardless of the specified essential health benefits, or opt for a new plan. 

"We believe this will help to alleviate some of the concern and frustration over the non-renewals," Ito said. "This is an opportunity for consumers to really look at the available plans and choose the best option for themselves. Whether it is their existing plan or a new ACA plan because it has more benefits, and may actually cost less."

The insurance carriers now have the choice as to whether they want to apply to the Insurance Division to have the existing plans continue. The Division will expedite the rate review process to meet the proper deadlines.

Insurance companies must now decide whether they will apply to continue those plans.

Those plans would not be available on the Hawaii Health Connector, and therefore not eligible for tax credits.

The President's decision extends the transition period for the ACA.

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The Hawaii Insurance Division oversees the Hawaii insurance industry; issues licenses, examines the fiscal condition of Hawaii-based companies, reviews rate and policy filings, investigates insurance related complaints

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From Center for Medicare and Medicaid Services

Dear Insurance Commissioners,       November 14, 2013  (emphasis added)

Some individuals and small businesses with health insurance coverage have been notified by their health insurance issuers that their coverage will soon be terminated. We understand that, in some cases, the health insurance issuer is terminating or cancelling such coverage because it would not comply with certain market reforms that are scheduled to take effect for plan or policy years starting on or after January 1, 2014, such as the new modified community rating and essential health benefits package standards.1 Although affected individuals and small businesses may access quality health insurance coverage through the new Health Insurance Marketplaces, in many cases with federal subsidies, some of them are finding that such coverage would be more expensive than their current coverage, and thus they may be dissuaded from immediately transitioning to such coverage.  

In light of this circumstance, under the following transitional policy, health insurance issuers may choose to continue coverage that would otherwise be terminated or cancelled, and affected individuals and small businesses may choose to re-enroll in such coverage. Under this transitional policy, health insurance coverage in the individual or small group market that is renewed for a policy year starting between January 1, 2014, and October 1, 2014, and associated group health plans of small businesses, will not be considered to be out of compliance with the market reforms specified below under the conditions specified below.2 We will consider the impact of this transitional policy in assessing whether to extend it beyond the specified timeframe.  

The specified market reforms are the portions of the following provisions of the Public Health Service Act that are scheduled to take effect for plan or policy years starting on or after January 1, 2014, and any corresponding portions of the Employee Retirement Income Security Act (ERISA) and the Internal Revenue Code (Code):  

• Section 2701 (relating to fair health insurance premiums);
• Section 2702 (relating to guaranteed availability of coverage);
• Section 2703 (relating to guaranteed renewability of coverage);
• Section 2704 (relating to the prohibition of pre-existing condition exclusions or other discrimination based on health status), with respect to adults, except with respect to group coverage;
• Section 2705 (relating to the prohibition of discrimination against individual participants and beneficiaries based on health status), except with respect to group coverage;3 
• Section 2706 (relating to non-discrimination in health care);
• Section 2707 (relating to comprehensive health insurance coverage);
• Section 2709, as codified at 42 U.S.C. § 300gg-8 (relating to coverage for individuals participating in approved clinical trials).  

The specified conditions are the following:  

• The coverage was in effect on October 1, 2013;4 
• The health insurance issuer sends a notice to all individuals and small businesses that received a cancellation or termination notice with respect to the coverage, or sends a notice to all individuals and small businesses that would otherwise receive a cancellation or termination notice with respect to the coverage, that informs them of (1) any changes in the options that are available to them; (2) which of the specified market reforms would not be reflected in any coverage that continues; (3) their potential right to enroll in a qualified health plan offered through a Health Insurance Marketplace and possibly qualify for financial assistance; (4) how to access such coverage through a Marketplace; and (5) their right to enroll in health insurance coverage outside of a Marketplace that complies with the specified market reforms. Where individuals or small businesses have already received a cancellation or termination notice, the issuer must send this notice as soon as reasonably possible. Where individuals or small business would otherwise receive a cancellation or termination notice, the issuer must send this notice by the time that it would otherwise send the cancellation or termination notice.  

State agencies responsible for enforcing the specified market reforms are encouraged to adopt the same transitional policy with respect to this coverage. Though this transitional policy was not anticipated by health insurance issuers when setting rates for 2014, the risk corridor program should help ameliorate unanticipated changes in premium revenue. We intend to explore ways to modify the risk corridor program final rules to provide additional assistance.  

Sincerely,  

Gary Cohen

Director

Center for Consumer Information and Insurance Oversight

PDF: Full Text Letter with footnotes