GPAHU – Supporting Quality Healthcare Solutions for All Pennsylvanians

Archive for August, 2010

LEG REG REVIEW 2010, 23rd Issue August 16

Aug 16

Posted by GPAHUAdmin in Legislative | No Comments

LEG REG REVIEW is a periodic newsletter produced by PHILLIPS ASSOCIATES, a professional lobbying and consultant firm located near the State Capitol.  It contains news on the legislative and regulatory scene in Pennsylvania that may be of interest to the Insurance and Business Communities.  It is a free member benefit for those who are members of the Pennsylvania Association of Health Underwriters (PAHU) or Manufacturers Association of South Central PA (MASCPA).  Subscription information may be obtained by contacting PHILLIPS ASSOCIATES at 717/728-1217 FAX 717/728-1164 or e-mail to xenobun@aol.com.  Please email jtrout2792@aol.com supplying both your name and e-mail address if you wish to be removed from this list.

ARIO HEADS TO DC

At month’s end, PA Insurance Commissioner Joel Ario will leave his position as PA’s chief regulator to become a key individual in the Obama Administration’s drive to implement the exchange component of the Patient Protection Affordable Care Act.  Specifically, Ario will be Director of the Office of Insurance Exchanges, part of the newly created Office of Consumer Information and insurance Oversight (OCIIO) within the Department of Health and Human Services.  One of his first responsibilities will be to work with staff in wading through numerous comments on how the Exchanges should be structured per a call from HHS for such input published in the August 3, 2010 Federal Register. NOTE: Comments are due to HHS by October 4, 2010 via email (http://www.regulations.gov) and by prompting the ‘More Search options’ tab; or by US mail to Centers for Medicare & Medicaid Services, Department HHS Attention: OCIIO-9989-NC; Box 8010, Baltimore, MD 21244-8010. Questions: Donna Laverdiere 301/492-4100

Ario was appointed to be PA Insurance Commissioner by Governor Ed Rendell after serving as Director of Insurance for the State of Oregon.  Acting Commissioner is Larry Pratter, Executive Deputy Counsel with the Insurance Department’s Office of General Counsel.

INSURANCE HEARINGS PLANNED

The House Insurance Committee plans two hearings.  First up is a hearing on House Bill 2610 in Philadelphia August 24.  This bill mandates that insurers cover hospice care or life extending treatment for children under 19.  The second hearing takes place September 14 in Harrisburg on House Bill 2188, legislation whose goal is to strengthen PA law regarding oversight and regulation of viatical settlements.

Other upcoming hearings of interest are:

-       August 18: House Labor Relations Committee on HB 2278 expanding family and medical leave

-       August 19:  House Health & Human Services Comm. on HB 1393 legalizing medically used marijuana

DESPITE OBAMA, HOUSE PASSES MULTI-PERIL FLOOD

Even though the Obama Administration sided with Big I, PIA, and insurance company trades to oppose making the National Flood Insurance Program one which also insures for wind damage, the US House of Representatives voted mostly along party lines for HR 1549 which would do that.  All PA Democrats voted for. All PA Republicans voted against.  Many in the insurance industry fear that expanding NFIP to include wind damage makes it fiscally unsound as well as unfairly competing with private sector insurers that offer wind damage protection.

POLITICS

  • Leg Reg Review reported that Rep. Marc Gergely (D-Allegheny) might seek the Senate seat vacated by resigning Sean Logan.  Since then, he announced that he is staying put as a candidate for re-election to his House seat.

GOVERNMENT NEWS

  • Another Rendell Cabinet member is leaving the Administration.  Department of General Services Secretary Jim Creedon is starting a consulting a consulting firm in the Lehigh Valley.  The Acting Secretary is former Deputy Secretary Elizabeth O’Reilly.
  • PA revenue figures for July 2010 showed $1.7 billion in collections.  When August figures are known, the Revenue Department will begin releasing figures comparing what was taken in versus the projection.  This FY Budget needs $28 billion in revenue and is already short by $280 million because the Federal Government is sending PA less money for medical assistance than was assumed.
  • Illinois domiciled Columbian Life Insurance Company has filed an application with Pennsylvania’s Insurance Department to merge with PA domiciled National Safety Life Insurance Company.
  • PA Health Care Cost Containment Council (PHC4) announced that it will convene September 9 in Harrisburg.

INSURANCE DEPARTMENT GIVES ACT 51 MINI COBRA GUIDANCE

In the August 14 PA Bulletin the Insurance Department issued Notice 2010-09 which states: This notice is issued to advise all entities subject to section 635.4 and section 635.5 of the act of May 17, 1921 (P. L. 682, No. 284), known as the Insurance Company Law of 1921, added by sections 5 764j) that a and 6 of Act 51 of 2010 (Act 51 or the Act) (40 P. S. § Federal premium assistance program is in existence for persons who had a qualifying event prior to May 31, 2010, that entitles those persons to Mini-COBRA coverage for a total of 15 months. In addition, those persons whose Mini-COBRA coverage was set to terminate prior to July 9, 2010, have the right to reinstate Mini-COBRA coverage for an additional 6 months of coverage beginning July 9, 2010. As set forth in the frequently asked questions on the Insurance Department’s web site at www.insurance.pa.gov and the pre-June 1, 2010, model notice referenced therein, questions concerning the Federal premium assistance program under the American Recovery and Reinvestment Act of 2009 (P. L. 111-5, 123 Stat. 115) and its successor laws may be directed to the Federal Centers for Medicare & Medicaid Services at http://www.continuationcoverage.net/.  Questions regarding this notice may be addressed to the Bureau of  Consumer Services, Room 1209, Strawberry Square, Harrisburg, PA 17120, ra-in-consumer@state.pa.us, or the toll-free automated hotline at (877) 881-6388.

US GOVERNMENT NEWS

  • The US Internal Revenue Department issued IR-2010-87 to remind small non profit organizations that their tax-exempt status is at risk if they do not file back returns.  The notice said that non-profits may check on a list published by IRS at their web site www.irs.gov to see if they are delinquent and, if so, they may file for an extension using Form 990-N.  Back returns are due October 15.  This emphasis on non-profit tax returns came from the Pension Protection Act of 2006 which mandated that all non-profits regardless of size must file a tax return to the IRS beginning in 2007.
  • Businesses may wish to know that the US Department of Labor issued rules governing break time requirements for nursing mothers as part of the implementation of the Patient Protection Affordable Care Act.  Effective March 23, 2010 was a requirement that employers give nursing mothers “reasonable break time” to express her milk in a location which shielded from view and free from intrusion.  The space cannot be a restroom. Part of the Fair Labor Standards Act, this measure affects employers with 50 or more employees.

PHILLIPS ASSOCIATES ANNOUNCES SUMMER CE

Eight four-credit Continuing Education courses are offered by PHILLIPS ASSOCIATES in late August and early September in Wilkes-Barre, Towanda, Warren and Lancaster.  Details; 717/732-7255.

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LEG REG REVIEW 2010, 22nd Issue August 9

Aug 9

Posted by GPAHUAdmin in Legislative | No Comments

LEG REG REVIEW is a periodic newsletter produced by PHILLIPS ASSOCIATES, a professional lobbying and consultant firm located near the State Capitol.  It contains news on the legislative and regulatory scene in Pennsylvania that may be of interest to the Insurance and Business Communities.  It is a free member benefit for those who are members of the Pennsylvania Association of Health Underwriters (PAHU) or Manufacturers Association of South Central PA (MASCPA).  Subscription information may be obtained by contacting PHILLIPS ASSOCIATES at 717/728-1217 FAX 717/728-1164 or e-mail to xenobun@aol.com.  Please email jtrout2792@aol.com supplying both your name and e-mail address if you wish to be removed from this list.

HHS SEEKS INPUT ON EXCHANGE DESIGN

In the August 3 Federal Register, the Department of Health and Human Services announced that it was seeking public input as to how the Exchanges and “Navigators” created by the Patient Protection Affordable Care Act would operate.  Comments must be received by October 4 at http://www.regulations.gov referencing Docket ID-HHS-OS-2010-0021 Planning and Establishment of State-Level Exchanges Request for Comments in Title 1 of the Patient Protection Affordable Care Act.  Hard copy submissions go to Honorable Kathleen Sibelius, Room 445-G, Hubert Humphrey Building, 200 Independence Avenue, SW, Washington, DC 20201.

RISK POOL OPERATIONAL

The PA Insurance Department announced that half the available slots for a PA High Risk Pool were applied for within the first 24 hours of a new program offering.  Dubbed “Fair Care”, the plan uses federal money from the Patient Protection Affordable Care Act to fund 3,500 medically uninsurable adults until 2014.  The plan is not without controversy with the PA Association of Health Underwriters (PAHU) charging that the Governor bypassed the General Assembly which has (or had) the authority to create programs.  HB 2514 and SB 507 were ignored as the Rendell Administration decided that it had the authority to create a new program without the legislature being involved.

PAHU also accused the Administration of ignoring the law regarding producer licensing as the High Risk Pool plan uses direct consumer Internet applications.  Another potential issue is what becomes of medically uninsurable individuals who apply but can’t get in.  They would be put on a waiting list similar to the adultBasic waiting list.  This may spill over into the legislative arena as some legislators such as House Majority leader Todd Eachus (D-Luzerne) seek to force the Blues into another Community Reinvestment Agreement where they dedicate some of their reserves to fund state programs for the uninsured.

INSURANCE BILL SIGNED INTO LAW

An omnibus insurance bill was signed into law by Governor Rendell as Act 51 of 2010.  House Bill 1251 (Costa-D-Allegheny) started out as a long-term care insurance bill but was amended during the legislative process to include a number of other areas.  (Text available at www.legis.state.pa.us) The new law:

  • Spells out how a person covered by a long-term care insurance policy or his/her representative may appeal an insurer’s decision that a benefit trigger is not met.  It says that the insurer must explain in plain language why it feels the benefit trigger was not met; an appeal must be filed in 180 days; an independent review process may come into play if the initial review sides with the insurer; the Insurance Department shall credential these independent review organizations
  • Extends PA’s mini-COBRA (groups 2-19 lives) to fifteen months if the Federal Government reinstitutes a COBRA subsidy such as that provided by ARRA (Stimulus Package)
  • Provides life insurer rules on assets and investments into such things as derivatives

LEGISLATIVE NOTES

  • Former Representative Elinor  (E.Z.) Taylor (R-Chester) passed away in Florida at the age of 89 on July 27. Elected in 1976, she was the former Caucus Secretary for the House GOP .  PERSONAL NOTE: She was a legislator of the old school, trying to broker a health insurance compromise in the contentious days of the Clinton health plan regarding what a minimum benefit package should be.  She was also recognized for her work to enhance the quality of post-high school education in the Commonwealth.
  • Rep. Barbara McIlvane-Smith (D-Chester) had a change of heart in deciding to run for re-election after all.  She had earlier opted not to, citing the inherent difficulties faced by reformers in Harrisburg.
  • Up and coming Democratic Senator Sean Logan (Westmoreland/Allegheny) is vacating his Senate seat for a private sector job August 24.  Rep. Marc Gergely (D-Allegheny) is expected to seek that seat.

BUDGET BRINGS GOOD NEWS, BAD NEWS TO PENNSYLVANIA

The U.S. Senate vote last week providing additional Medicaid money to states is good news for PA since the FY 2010-11 Budget includes this $850 million assumption.  This is good news in that Governor Rendell said that thousands of state workers could be laid off if the money was not forthcoming.  It’s not without a bad side however.  New Federal money to PA will only be $600 million, leaving Rendell with the task of cutting $250 million from the new state budget.  Adding to this fiscal stress  is the $240 million-plus hole in transportation funding because tolling I-80 was rejected by the Federal Government, the $801 million MCARE money used for last year’s budget that the courts said was taken improperly and a looming pension crisis coupled with the fact that Stimulus Package money goes away after this FY.

PHILLIPS ASSOCIATES CE UPDATE

PHILLIPS ASSOCIATES has announced what it calls its ‘Summer Sizzler’ round of continuing education in August and early September.  (Details at 717/732-7255) These four-credit courses include:

-       Health Insurance Public Policy Issues in Towanda August 31 and Lancaster September 2

-       Insurance Privacy Compliance in Towanda August 31 and Lancaster September 2

-       D&O in Warren September 1

-       Workers’ Compensation in Warren September 1

-       Commercial Insurance Flash Points in Wilkes-Barre August 26

-       E&O in Depth in Wilkes-Barre in Wilkes-Barre August 26

INDUSTRY NOTES

  • SPARKS Clinics are now approved in Pennsylvania, Maryland, and Delaware for four CE credits.  Spanning nine locations from September 13-24, SPARKS attracts about 600 agents annually.  The Clinics are sponsored by Mutual Insurance Companies seeking to remind agents that they are a viable choice in meeting consumer insurance needs.  Details: www.sparksclub.com .
  • Pennsylvania agency Johnson Kendall Johnson of Newtown, PA was featured in the August 2010 Rough Notes magazine.
  • NAIC is looking at life insurance retained asset accounts (RAAs) according to a July 27 release from the regulators’ organization (www.naic.org ). While stating that RAAs have generated few complaints, NAIC wants to make sure that consumer disclosures are adequate.  PA legislation may be introduced by Rep. Robert Matzie (D-Allegheny).

FLOOD INSURANCE NEWS

The National Flood Insurance Program (NFIP) announced that October 1 Manual changes are now available (http://www.nfipservice.com/stakeholder/pdf/bulletin/w-10079.txt ).

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