panel 3: exploring the changes to insurers - Charlotte Chamber of ...

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HEALTH CARE REFORM LEGISLATION IN PERSPECTIVE • Landmark legislation, but much still to be accomplished to meet Administration’s goals • Access • Affordability • Cost Control • Lots of new regulations to be issued • 1,045 references to “the Secretary shall determine………….” • Reconciliation bill could only “fix” budget-related issues, much more needs to be defined, established, and/or clarified – even effective date of many provisions uncertain , such as auto-enrollment and CLASS • Many key employer regulations expected to come jointly from HHS, DOL and IRS – typically a slow process • Some uncertainties remain about the legislation’s outcome and even future • States challenging constitutionality and ability to implement (e.g., Medicaid revisions) – HHS likely to give more discretion/authority to states as long as satisfy federal minimum guidelines 4
HEALTH CARE REFORM PANEL QUESTIONS ‣ Garland: There are a lot of provisions in this bill. What do businesses need to focus on today? ‣ Mark: As an insurance company, how do you define small vs. large group employer sponsored plans? And, what are the 3 primary HCR challenges handling small groups vs. large groups? ‣ Barbara: The new HCR law set numerous dates for implementing the provisions of reform. The administration has publicly asked insurers to implement certain provisions earlier than required, on a voluntary basis (e.g., Age 26 dependents, prohibit pre-existing condition exclusion for dependents under age 19, various disclosure and reporting requirements) As an insurer, how have you reacted - how is this affecting your business? ‣ Garland: As of January 1, 2011 the new HCR law requires insured health plans to comply with a medical loss ration (MLR) maximum of 85% (for group plans) 80% (for individual plans. As an insurer, what will this mean to employer sponsors renewing an insured medical plan on or after January 2011? ‣ Barbara: The new HCR law allows each State to establish a State Insurance Exchange by 2014. As an insurer, what direct benefits will the exchange create for businesses in North Carolina? ‣ Mark: How will this legislation affect our health care costs?
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Page 3: PANEL FORMAT ‣ 6 questions ‣ Ea

panel 3: exploring the changes to insurers - Charlotte Chamber of ...

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