Posts Tagged 2012

LEG REG REVIEW 2012, 35th Issue December 27, 2012

Dec 29

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 717/232-7005 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.

Dear Professional Associates and Friends,

As 2012 winds down, it is only appropriate that a person and a business take stock of things. Where did we want to be at year’s end and what do we do for the next year are normal questions that I think everyone asks at this time. For me and my firm, we are where we wanted to be, providing Continuing Education for insurance producers and providing lobbying, and other professional services to a strong range of clients. This work includes answering hundreds of individual questions about the Patient Protection Affordable Care Act (PPACA) and scores of presentations promoting clarity where possible about this complex law. In lobbying, our efforts have been to protect your vital interests as well as seeking positive legislation, all with a backdrop of educating people on how the system works and how an individual can make a difference. My pledge to everyone is to continue this level of service in 2013. I am particularly blessed to have worked with exceptional people, firms, and associations like yourselves. Thank you for letting myself and PHILLIPS ASSOCIATES be a resource for you. I wish all the best for you this holiday season and for the New Year.

Sincerely, Vince Phillips

***************************************************

COMMITTEE CHAIRS NAMED

House Republican and Democratic Committee Chairs were announced by the House. Senate Republicans announced GOP Chairs for the 2013-14 legislative session. The list appears below.

Senate Standing Committee Chair Assignments:

Aging & Youth – Sen. Bob Mensch (R-24) ; Appropriations – Sen. Jake Corman (R-34)

Agriculture & Rural Affairs – Sen. Elder Vogel, Jr. (R-47) ; Banking & Insurance – Sen. Don White (R-41

Communications & Technology – Sen. Randy Vulakovich (R-40)

Community, Economic & Recreational Development – Sen. Kim L. Ward (R-39)

Consumer Protection & Professional Licensure – Sen. Robert M. Tomlinson (R-6)

Education – Sen. Mike Folmer (R-48) ; Environmental Resources & Energy – Sen. Gene Yaw (R-23)

Finance – Sen. Mike Brubaker (R-36) ; Game & Fisheries – Senator Richard Alloway (R-33)

Intergov’tal Operations – Sen.Scott E. Hutchinson (R-21) ; Judiciary – Sen. Stewart J. Greenleaf (R-12)

Labor & Industry – Sen. John R. Gordner (R-27) ; Law & Justice – Senator Charles T. McIlhinney, Jr. (R-10)

Local Gov’t – Sen. John H. Eichelberger, Jr. (R-30) ; Public Health & Welfare – Sen. Patricia H. Vance (R-31)

Rules & Executive Nominations – Sen. Dominic Pileggi (R-9) ; State Government – Sen. Lloyd K. Smucker (R-13)

Transportation – Sen. John C. Rafferty, Jr. (R-44) ; Urban Affairs & Housing – Sen. David G. Argall (R-29)

Veterans Affairs & Emergency Preparedness – Sen. Lisa Baker (R-20)

HOUSE COMMITTEE CHAIRS: Aging and Older Adult Services: Republican: Rep. Tim Hennessey, 26^th legislative district, Chester County. Democrat: Rep. Steve Samuelson, 135^th legislative district, Lehigh and Northampton counties. Agriculture and Rural Affairs: Republican: Rep. John Maher, 40^th legislative district, Allegheny and Washington counties. Democrat: Rep. Joseph Petrarca, 55^th legislative district, Armstrong and Westmoreland counties. Children and Youth: Republican: Rep. Kathy Watson, 144^th legislative district, Bucks County. Democrat: Rep. Louise Bishop, 192^nd legislative district, Philadelphia County. Commerce: Republican: Rep. Chris Ross, 158^th legislative district, Chester County. Democrat: Rep. W. Curtis Thomas, 181^st legislative district, Philadelphia County. Consumer Affairs: Republican: Rep. Robert Godshall, 53^rd legislative district, Montgomery County. Democrat: Rep. Peter J. Daley, 49^th legislative district, Fayette and Washington counties. Education: Republican: Rep. Paul Clymer, 145^th legislative district, Bucks County. Democrat: Rep. James Roebuck, 188^th legislative district, Philadelphia County. Environmental Resources and Energy: Republican: Rep. Ron Miller, 93^rd legislative district, York County. Democrat: Rep. Greg Vitali, 166^th legislative district, Delaware County. Finance: Republican: Rep. Kerry Benninghoff, 171^st legislative district, Centre and Mifflin counties. Democrat: Rep. Phyllis Mundy, 120^th legislative district, Luzerne County. Game and Fisheries: Republican: Rep. Martin Causer, 67^th legislative district, Cameron, Potter and McKean counties. Democrat: Rep. Gary Haluska, 73^rd legislative district, Cambria County. Gaming Oversight: Republican: Rep. Tina Pickett, 110^th legislative district, Bradford, Sullivan and Susquehanna counties. Democrat: Rep. Rosita Youngblood, 198^th legislative district, Philadelphia County. Health: Republican: Rep. Matt Baker, 68^th legislative district, Bradford and Tioga counties. Democrat: Rep. Flo Fabrizio, 2^nd legislative district, Erie County. Human Services: Republican: Rep. Gene DiGirolamo, 18^th legislative district, Bucks County. Democrat: Rep. Angel Cruz, 180^th legislative district, Philadelphia County. Insurance: Republican: Rep. Nick Micozzie, 163rd legislative district, Delaware County. Democrat: Rep. Tony DeLuca, 32^nd legislative district, Allegheny County. Judiciary: Republican: Rep. Ron Marsico, 105^th legislative district, Dauphin County. Democrat: Rep. Thomas Caltagirone, 127^th legislative district, Berks County. Labor and Industry: Republican: Rep. Mario Scavello, 176^th legislative district, Monroe County. Democrat: Rep. Bill Keller, 184^th legislative district, Philadelphia County. Liquor Control: Republican: Rep. John Taylor, 177^th legislative district, Philadelphia County. Democrat: Rep. Paul Costa, 34^th legislative district, Allegheny County. Local Government: Republican: Rep. Kate Harper, 61^st legislative district, Montgomery County. Democrat: Rep. Bob Freeman, 136^th legislative district, Northampton County. Professional Licensure: Republican: Rep. Julie Harhart, 183^rd legislative district, Lehigh and Northampton counties. Democrat: Rep. Harry Readshaw, 36^th legislative district, Allegheny County. State Government: Republican: Rep. Daryl Metcalfe, 12^th legislative district, Butler County. Democrat: Rep. Mark Cohen, 202^nd legislative district, Philadelphia County. Tourism and Recreational Development: Republican: Rep. Jerry Stern, 80^th legislative district, Bedford and Blair counties. Democrat: Rep. Thaddeus Kirkland, 159^th legislative district, Delaware County. Transportation: Republican: Rep. Dick Hess, 78^th legislative district, Bedford, Fulton and Huntingdon counties. Democrat: Rep. Michael P. McGeehan, 173^rd legislative district, Philadelphia County. Urban Affairs: Republican: Rep. Keith Gillespie, 47^th legislative district, York County. Democrat: Rep. Ted Harhai, 58^th legislative district, Fayette and Westmoreland counties. Veterans Affairs and Emergency Preparedness: Republican: Rep. Stephen E. Barrar, 160^th legislative district, Chester and Delaware counties. Democrat: Rep. Chris Sainato, 9^th legislative district, Beaver and Lawrence counties.

REGULATORY NOTES

IRS announced increased 2013 deductibility limits for long-term care insurance. For example, for those more than 60 and below 70, the deductible limit for 2013 is $3,640 versus $3,500 in 2012. (www.aaltci.org/tax )
Two surplus lines changes for 2013: First, the Form 1609-PR will no require that the required three declinations be shown. That in no way removes the requirement however. This was from a Bulletin issued September 11, 2012 by the PA Surplus Lines Association (PSLA) with an effective date of January 1, 2013. The second PSLA Bulletin issued December 11, 2012 reports changes on the Gross Premium Tax Form RCT-123 requiring Social Security numbers for both tax preparer and the corporate officer. (Details: www.pasla.org)

Tags: 2012, 35th Issue December 27, GPAHU, LEG REG REVIEW 2012, Legislative Review, NAHU, PAHU, Phillips Associates, Vince Phillips

LEG REG REVIEW 2012, 34th Issue December 17, 2012

Dec 17

Posted by GPAHUAdmin in Legislative | No Comments

PA DECIDES ON EXCHANGES

The Corbett Administration decided not to establish a state-based exchange and to default to HHS to set up a federally-facilitated exchange. On December 12, Commissioner Michael Consedine and the Governor’s staff held an advance briefing for stakeholder groups such as PAHU. In the briefing, Consedine stressed that the decision was not political, that had it been political, the decision would have been announced some time ago. Rather, he pointed to the painstaking way the Department approached the decision through Forums (hearings) and via in-depth studies of the PA insurance market as well as many implementation questions. Some of the basic questions remained unanswered by HHS despite the state‘s submission of 26 questions. Examples included:

- What costs will PA have to meet?

- Will PA’s Insurance Department have any regulatory authority?

The Commissioner also said that the so-called partnership exchange was actually a federal exchange with PA Insurance Department simply implementing federal rules rather than a true partnership. The door was left open to possibly seeking a transition from a federally facilitated exchange to a state-based exchange at some future date. According to Corbett, Pennsylvania is one of 28 states opting to let the Federal Government operate the exchange. A link to the Corbett press release appears below:

http://www.portal.state.pa.us/portal/server.pt?open=512&objID=17319&PageID=502655&mode=2&contentid=http://pubcontent.state.pa.us/publishedcontent/publish/cop_hhs/insurance/news_and_media/news___media/articles/december_12__2012.html

The Pennsylvania Association of Health Underwriters (PAHU) issued the following statement in response to the state’s decision:

The Pennsylvania Association of Health Underwriters (PAHU) understands why the Corbett Administration made the decision it did. Despite our preference for a state-based exchange, we realize that the US Department of Health and Human Services (HHS) has not presented clear guidance to states as to the extent to which state regulatory authority would be preserved in a state-based exchange. Other fundamental core questions are how or if the state would be able to oversee marketing of the exchanges particularly by unlicensed Navigators per the Affordable Care Act. A third concern is cost to Pennsylvania taxpayers given the fiscal crisis PA now faces. HHS may provide start-up money for a state-based exchange but the Commonwealth needed to know what costs PA taxpayers would incur to continue operating a state-based exchange. Answers to those questions from the Federal Government were not forthcoming.

Now that the decision has been made by the Corbett Administration, at least insurance agents and brokers can better advise their employer and individual clients as to what to expect from the new insurance system created by the Affordable Care Act effective in 2014.

CONSEDINE ELECTED TO NAIC POST

Insurance Commissioner Michael Consedine was elected to fill the position of Secretary-Treasurer by the National Association of Insurance Commissioners (NAIC) at its December meeting. This post means that Consedine is in line to chair the NAIC in the future. He already chairs an important committee which addresses issues of federal-state regulation in those states which choosing not to have a state-based exchange.

MEDICAID EXPANSION TO WAIT

Another major question received an answer from Department of Public Welfare (DPW) Secretary Gary Alexander in testimony before the House Energy & Commerce Committee on Health subcommittee December 13. Alexander said that PA could not afford to expand Medicaid eligibility per the Patient Protection Affordable Care Act (PPACA). According to the DPW Secretary, full expansion to 133% of the Federal Poverty Level would mean an additional 800,000 to one million people receiving taxpayer-subsidized benefits. 40% of Pennsylvanians would be receiving health care through a federal government program (25% Medicaid and 15% Medicare). Costs to the Commonwealth would start with $250 implementation costs borne by the state administratively before the expansion because PA Medicaid would have to convert to federal methodology in calculating the Modified Adjusted Gross Income (MAGI) eligibility threshold. In addition, PA’s match to the increased entitlement would amount to $883 million annually starting in 2020-21. The testimony came against a backdrop of HHS refusing to partially funding a partial increase in Medicaid eligibility—if a state wanted the HHS increase, it would have to fully meet the higher standard. A link to his remarks appears below.

http://energycommerce.house.gov/sites/republicans.energycommerce.house.gov/files/Hearings/Health/20121213/HHRG-112-IF14-WState-AlexanderG-20121213.pdf

Alexander’s numbers contrasted with a report issued by the Kaiser Family Foundation which put the Pennsylvania cost of full Medicaid expansion at $2.84 billion from 2013-2022 but said that this increase would be mitigated by having less uncompensated care to hospitals. The federal increase in Medicaid over the same period would be a projected $37.84 billion. The net cost would be $1.96 billion to PA taxpayers from required state matching funds. A link to the report appears below.

http://www.kff.org/medicaid/upload/8384.pdf

HHS ISSUES MORE PPACA RULES

On December 10, HHS issued a set of Frequently Asked Questions on its blog at hhs.gov, a link to which appears below. These FAQs are designed to provide guidance to states nearing the now past December 16 deadline as to its decision re state-based or federally-facilitated exchange. One question adds an additional cost element.

8. How will the Federally-Facilitated Exchange be funded?

A. To fund the operation of the Federally-Facilitated Exchange, we proposed for comment in the draft Payment Notice that participating issuers pay a monthly user fee to support the operation of the Federally-Facilitated Exchange. For the 2014 benefit year, we proposed a monthly user fee rate that is aligned with rates charged by State-Based Exchanges. While we proposed that this rate be 3.5 percent of premium, it may be adjusted in the final Payment Notice to take into account State-Based Exchange rates. Exchange user fees will support activities such as the consumer outreach, information and assistance activities that health plans currently pay themselves.

http://cciio.cms.gov/resources/files/exchanges-faqs-12-10-2012.pdf

STAFF UPDATES AT THE DEPARTMENT

The PA Insurance Department has seen some staff changes relevant to policy and legislative affairs. As reported previously, Legislative Liaison Kari Kissinger was moved to serve as Deputy Secretary for Legislative Affairs directly for Governor Corbett. Named to replace her at the Department is Kristen Ortis, now with the Ridge Policy Group and formerly a staffer for US representative Todd Platts. She starts December 27. The other major change is the elevation of Matthew O’Donnell to Governor Corbett’s staff from his position as the Department’s Policy Director. At the Department, he was responsible for much of the work connected with Pennsylvania’s analysis of PPACA implementation. This research framed the foundation of Governor Corbett’s decision not to establish a state-based exchange.

Tags: 2012, 34th Issue December 17, GPAHU, LEG REG REVIEW 2012, Legislative Review, NAHU, PAHU, Phillips Associates, Vince Phillips

LEG REG REVIEW 2012, 33d Issue December 3, 2012

Dec 7

Posted by GPAHUAdmin in Legislative | No Comments

HOUSE, SENATE MAINTAIN LEADERSHIP TEAMS

In November, the four caucuses of the General Assembly re-elected their leadership for the 2013-14 legislative session with only two exceptions in order to replace retired lawmakers.

HOUSE REPUBLICANS

Speaker Sam Smith (although there will need to be a vote by the full House in January)

Majority Leader Mike Turzai

Majority Whip Stan Saylor

Majority Caucus Chair Sandra Major

Majority Appropriations Chair Bill Adolph

Majority Caucus Administrator Richard Stevenson

Majority Caucus Secretary Mike Vereb

Majority Policy Committee Chair Dave Reed

HOUSE DEMOCRATS

Minority Leader Frank Dermody

Minority Whip Mike Hanna

Democratic Caucus Chair Dan Frankel

Minority Appropriations Chair Joe Markosek

Democratic Caucus Administrator Neal Goodman (replacing Ron Buxton who retired from the House)

Democratic Caucus Secretary Ron Waters (replacing Jennifer Mann who retired from the House)

Democratic Policy Committee Chair Mike Sturla

SENATE REPUBLICANS

President Pro Temp Joe Scarnati (requiring a Senate vote in January)

Majority Leader Dominic Pileggi

Majority Whip Pat Browne

Majority Caucus Chair Mike Waugh

Majority Caucus Secretary Bob Robbins

Policy Committee Chair Edwin Erickson

SENATE DEMOCRATS

Minority Leader Jay Costa

Minority Whip Anthony Williams

Democratic Caucus Chair Richard Kasunic

Democratic Caucus Secretary Tina Tartaglione

Democratic Caucus Administrator Wayne Fontana

Policy Committee Chair Lisa Boscola

MISC LEGISLATIVE NOTE

Governor Corbett signed another insurance bill into law in November. Senate Bill 201 or Act 207 of 2012 (Rafferty-R-Montgomery), is a parity measure designed to ensure equal treatment, conditions etc. by insurers for retail pharmacies versus mail-order pharmacies. It was long sought by the pharmacists who maintained that insurance carriers created disincentives for consumers to choose a neighborhood drug store over a mail-order operation.

PCRB FILES WORKERS COMP LOSS COST

On November 28, the Pennsylvania Compensation Rating Bureau (PCRB) presented a Workers’ Compensation loss-cost filing that, if approved, would become effective April 1, 2013. The filing proposes a 4.01 percent overall loss cost decrease. Despite overall reductions, selected class descriptions will see increases: Mushroom Grower (0008) +11.9%; Spinning & Weaving (132) +9.6%; Electronic Power Equipment Manufacturing (473) +22.3%; Attorneys (956) +5.9%. Several of the larger reductions were: Federal Coal Mine Cover load (0164) -25%; Paper Coating & Finishing (263) -11.2%; Electronic Power Equipment Manufacturing (474) -22.3%; Aircraft Manufacturing (744) -20.5%; Accountants (962) -16.7%.

FYI, Insurance Company class (984) remained the same but Banks (988) increased 4.5%. The PCRB document is Circular 1610 and is available at www.pcrb.com.

THIS JUST IN…ANOTHER PPACA REG

There is something about late Friday afternoons and HHS. Announced today per a November 30 article in National Underwriter’s LifeHealthPro (www.lifehealthpro.com ) are new proposed rules from the Centers for Medicare Medicaid Services (CMS) under PPACA which are to be published in the Federal Register December 7. Among other things, the proposed Rule:

- Applies to federally-facilitated Exchanges, not state-based Exchanges

- Broker compensation under a federally-facilitated Exchange should be similar to non-Exchange plans but non-federally facilitated Exchange brokers would not be listed on the federal web site

- Rules on reinsurance and the $10 billion in insurer payments going to the Federal Government in 2014

PENNSYLVANIA BUDGET NUMBERS

Although the November numbers are not just out, October budget revenues continue to inch their way back. The General Fund collected $2 billion in October, bringing the year-to-date total $8.1 billion or one percent above estimates for the fiscal year which began July 1. October specifically saw $71.5 million or 3.6% more than expected. The only major tax categories showing below estimate revenues were inheritance taxes and cigarette, liquor, malt beverage and table games.

REGULATORY UPDATES

Bankers Life and Casualty Company has entered into a multi-state settlement with a number of state departments of insurance including Pennsylvania regarding various claims and claims procedure violations as a follow up to a 2007 regulatory review. The $3.2 million from Bankers Life and Casualty will be divided between the states and involved the company’s annuity, life and long-term care lines of insurance.
John Hancock has joined the ranks of a number of leading national life insurance companies who have agreed to use the Social Security Administration’s Death Master File in order to better identify those policyholders who have died so as to locate and pay beneficiaries. Their settlement involved $13.3 million to be shared among states participating in the multi-state settlement between John Hancock and insurance regulators.

NFIP OFFERS FREE DECEMBER AGENT TRAINING

In December, the National Flood Insurance Program (NFIP) is offering free webinars on Elevation Certificates on the 18^th and on Flood Map Changes on the 4^th, 11^th and 12^th, the links to which appear below.

Elevation Certificate: http://www.h2opartnersusa.com/register/ecmadeez-20121218.shtml

Flood Mapping: http://www.h2opartnersusa.com/register/mapchanges-20121211.shtml

Tags: 2012, 33d Issue December 3, GPAHU, LEG REG REVIEW 2012, Legislative Review, NAHU, PAHU, Phillips Associates, Vince Phillips

LEG REG REVIEW 2012, 32d Issue November 26, 2012

Nov 30

Posted by GPAHUAdmin in Legislative | No Comments

2013 SESSION DAYS ANNOUNCED

SENATE

January 1, 22, 23, 28, 29, 30

February 4, 5, 6, 11, 12, 13

March 11, 12, 13, 18, 19, 20

April 8, 9, 10, 15, 16, 17, 29, 30

May 1, 6, 7, 8, 9, 13, 14

June 3, 4, 5, 10, 11, 12, 17, 18, 19, 24, 25, 26, 27, 28

**************************************************

HOUSE

January 1, 14, 15, 16, 22, 23

February 4, 5, 6, 11, 12, 13

March 11, 12, 13, 18, 19, 20

April 8, 9, 10, 15, 16, 17, 22, 23, 24

May 6, 7, 8, 13, 14, 15

June 3, 4, 5, 10, 11, 12, 17, 18, 19, 20, 24, 25, 26, 27, 28

HHS ISSUES PPACA RULES

On November 26, HHS’ massive new regulations dealing with parts of the Patient Protection Affordable Care Act (PPACA) appeared in the Federal Register but did not include anticipated Exchange rules.

First, essential health benefits (EHBs) were addressed. Earlier, states were given options of deciding between several benefit scenarios for EHB benchmark plans and were given a deadline of October 1, 2012 to tell HHS which EHB scheme would be used. PA sent a letter seeking clarification. This proposed rule spells out what the default would be for EHBs for those states not deciding on their own.

“Specifically, we propose that HHS would supplement the category of benefits in the default base-benchmark plan with the first of the following options that offer benefits in that particular EHB category: (1) The largest plan by enrollment in the second largest product in the state’s small group market as defined in § 155.20; (2) the largest plan by enrollment in the third largest product in the state’s small group market as defined in § 155.20; (3) the largest national FEHBP plan by enrollment across states that is described in and offered to Federal employees under 5 U.S.C. 8903”.

The law directs that EHB be equal to benefits covered by a typical employer plan and cover at least the following 10 general categories: Ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.

The rule also addresses a provision in PPACA that says that state mandated benefits not included in the EHBs offered by the Qualifying Health Plans for Exchanges must be paid for by the state. It says that EHBs would be presumed to include any states mandates enacted before January 1, 2012.

Actuarial value used for determining the coverage level (bronze, silver, gold, platinum) was also included in this rule.

https://www.federalregister.gov/articles/2012/11/26/2012-28362/patient-protection-and-affordable-care-act-standards-related-to-essential-health-benefits-actuarial

Wellness programs were addressed in another November 26 rule with HHS saying that smokers in a cessation class would be eligible for an up to 50% offset to their premium. Other than that, the maximum discount for others achieving wellness goals (weight, blood pressure, cholesterol) would be increased from 20 to 30%.

https://www.federalregister.gov/articles/2012/11/26/2012-28361/incentives-for-nondiscriminatory-wellness-programs-in-group-health-plans

A third HHS rule said that the transition to a 3-1 rate band where no one’s rate could be more than three times another’s would be more gradual. Critics pointed to an outcome of compressing the rate bands which would mean dramatic increases for younger, healthier individuals even as premiums for older and more claims-prone populations would decrease. The rule would phase in yearly rate increases for persons aged 21-63 on a gradual basis instead of a sudden sticker shock. A single band would be used for children up through 19 and persons 64 and older.

https://www.federalregister.gov/articles/2012/11/26/2012-28428/patient-protection-and-affordable-care-act-health-insurance-market-rules-rate-review#h-8

There was also an intriguing portion of this proposed rule that may need to be clarified with the PA Insurance Department. In describing the rule, HHS says: “Lastly, the proposed rule would include as a minimum standard a more detailed marketing standard in connection with guaranteed availability that had not been included in the earlier HIPAA rule. Nonetheless, it is similar to the guidance we provided in Health Care Financing Administration Bulletin No. 98-01 that interpreted the HIPAA provisions related to guaranteed availability in the individual and small group markets. Bulletin No. 98-01 stated that the PHS Act prohibited issuers from setting agent commissions for sales to HIPAA-eligible individuals and small groups so low that they were discouraged from marketing policies to such individuals and groups. [54] Pursuant to section 1311(c)(1)(A) of the Affordable Care Act, QHP issuers are required to comply with applicable state laws and regulations regarding marketing by health insurance issuers and not employ marketing practices or benefit designs that will have the effect of discouraging the enrollment of individuals with significant health needs in QHPs (§ 156.225). The proposed rule would adopt this standard and apply it to the entire marketplace in order to ensure consistency in the marketing of plans inside and outside of the Exchanges and leverage existing state oversight mechanisms.”

ELECTION CLOSE-OUT

Republicans won all three of the tightly contested races that were still pending after Election Day. Re-elected are Rick Saccone (Allegheny/Washington), Justin Simmons (Lehigh), and Nick Micozzie (Delaware). Micozzie chairs the House Insurance Committee, of which Simmons is a member. NOTE: There is a Democratic vacancy on the committee with the election of Rep. Matt Smith (D-Allegheny) to the PA Senate.

Tags: 2012, 32d Issue November 26, GPAHU, LEG REG REVIEW 2012, Legislative Review, NAHU, PAHU, Phillips Associates, Vince Phillips

LEG REG REVIEW 2012, 31st Issue November 12, 2012

Nov 13

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.

ELECTION RACE UPDATE

In the Election issue of Leg Reg Review (November 7), there were three House races with an uncertain final outcome. All three involved Republican incumbents – Rick Saccone (Allegheny/Washington), Justin Simmons (Lehigh), and Nick Micozzie (Delaware). As of Friday 4:30 pm, Department of State vote totals showed all three Republicans ahead as follows:

- Rick Saccone (R ) v. Dave Levdansky (D) – 14,274 to 14,238 with the Republican ahead by 36 votes

- Nick Micozzie (R ) v. Sheamus Bonner (D) – 14,003 to 14,238, a GOP edge of 354 votes

- Justin Simmons (R ) v. Kevin Deely, Jr. (D) – 14,226 to 13,664, the GOP by 562 votes

The other squeaker was Democrat Mark Painter’s upset victory over incumbent Rep. Thomas Quigley (R-Montgomery), 14,801 to 14,585, a difference of only 216 votes!

PAHU ISSUES POST-ELECTION MESSAGE to AGENTS ON PPACA

The PA Association of Health Underwriters issued an election commentary November 9.

“While many may have wished for a different outcome in the election’s verdict on the Patient Protection Affordable Care Act (PPACA), the voters have returned to office the prime architect of this far-reaching law. This means that PPACA has survived a Supreme Court test and an electoral referendum and is the law of the land. It will be implemented. How should insurance brokers respond? First, clients, particularly employers, need guidance in understanding their compliance requirements under the law. How many businesses know about their notice and reporting requirements? How many know how the exchanges will work? (Sorry, the Government doesn’t know either!) Knowing that you are with clients every step of the way reinforces your loyalty to them and their loyalty to you. Health insurance is not Travelocity. Those decisions are complex. Your role is to help clients understand and cope with these forced changes. Second, on the state level, reach out to lawmakers in the state legislature and educate them as to your role in the marketplace. What do brokers do? Some legislators think you just sell insurance. Sales are a small part of what you do. In the new world order, even if PA Governor Corbett decides to allow a federally-facilitated exchange instead of crafting a Pennsylvania state-based exchange, the Agent Community must still weigh in on proper training and regulation of Navigators to prevent unlicensed persons and groups from doing what Act 147 says that only licensed insurance producers can do.

The PAHU document also emphasized the importance of staying active in local associations and to not forget advocacy in removing producer compensation from the Medical Loss Ratio calculation. A majority of Pennsylvania’s congressional delegation sponsored HR 1206 in the concluding session of Congress. This will again be NAHU’s top national priority next year.

HHS EXTENDS EXCHANGE DEADLINE

In a November 9 letter to Governors, HHS Secretary Sibelius extended the November 16 deadline for states seeking a state-based exchange to submit a declaration letter by December 14 and Blueprint to HHS by February 15, 2013.

GOVERNOR SIGNS PHARMACY BILL INTO LAW

On November 1, Governor Tom Corbett signed Senate Bill 201 (Rafferty-R-Montgomery) into law as Act 207 of 2012. This legislation prevents health insurers from imposing a copayment, fee, and limitation on benefits or other conditions on individuals not imposed on consumers’ use of mail order pharmacies. The law also requires an impact study on cost and access for Rx drugs in 18 months. Act 207 becomes effective 120 days after being signed into law.

UNFINISHED BUSINESS?

The General Assembly returns this week to thank retiring or defeated legislators for their service to the Commonwealth and to discuss leadership for the 2013-14 session. Technically on the House calendar for November 14 is a bill of interest to some in the insurance community. Senate Bill 1591 (White-R-Indiana) would eliminate insurers’ extensive medical malpractice liability claims information to the Insurance Department, now an annual requirement. Realistically, the legislative work of the General Assembly is done.

CMS EXTENDS MEDICARE DEADLINE FOR SANDY

CMS has extended the December 7 Medicare option to enroll in Medicare Advantage or choose a prescription plan under Part D for people impacted by Superstorm Sandy. The extension is not automatic however. Persons must call 1(800) 633-4227 and enrollment can take place over the phone. Anyone not meeting the deadline to change or having called in will be automatically renewed in whatever Medicare and Medicare Part D plan they have now.

REGULATORY UPDATE

The Independent Regulatory Review Commission (IRRC) has sent Regulation 11-249 (Qualified and Certified Reinsurers) back to the Insurance Department. After review, IRRC concluded that the draft regulation was not consistent with NAIC cross references and said that the Commissioner should not have sole discretion as to whether an occurrence is “catastrophic.” Rather, IRRC argued, the term “catastrophic occurrence” should be defined by an objective means.
The November 10 PA Bulletin has published a reorganization chart of the Department of Banking and Securities to show the merger of the former PA Securities Commission into the Banking Department (www.pabulletin.com)
Governor Corbett issued Executive Order 2012-4 establishing the Governor’s Innovation Office within the Office of Administration to improve efficiency and productivity in state government operations through innovation, inter-agency coordination and how best to utilize resources to achieve that goal.

HURRICANE CLAIMS AND REPAIRS

Both the Insurance Department and the Office of the Attorney General issued press releases concerning Super Storm Sandy. The Department advised consumers that flood damage is not covered by homeowners and that damage from a power outage may not be covered unless the power source is located on the property. Attorney General Linda Kelly warned PA residents to beware of scams when contracting for home repairs. She identified repair scams, government loan and grant schemes, fraudulent fundraising efforts and price gouging (20% above the normal market price) as areas of particular concern to her office. People wishing to complain should contact the AG at www.attorneygeneral.gov (Click Complaints button on home page) or 800/441-2555.

Links to the two releases appear below.

LOOK FOR UPDATES ON THE NEW LEGISLATORS in upcoming issues of Leg Reg Review. Even though most new legislators in the House replaced those of the same party in the open seats (14 Democrats, seven Republicans) the newcomers come from diverse backgrounds.

Tags: 2012, 31st Issue November 12, GPAHU, LEG REG REVIEW 2012, Legislative Review, NAHU, PAHU, Phillips Associates, Vince Phillips

LEG REG REVIEW 2012, 30th Issue November 7, 2012

Nov 10

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.

DEMOCRATS TAKE TOP OFFICES

In addition to winning the state for Barack Obama, Pennsylvania Democrats carried the day in the other top races. Senator Bob Casey, Jr. won with 53.6% over Tom Smith (44.7%). Kathleen Kane triumphed over David Freed 56.1% to 41.6% in the race for Attorney General. A Democrat has never held the office of Attorney General. State Treasurer Rob McCord won re-election 52.5% to 44% over Diana Irey Vaughan. The closest race pitted two incumbent House members against each other but ultimately Democrat Eugene DePasquale from York overpowered Republican John Maher (Allegheny/Washington) 49.7% to 46.5%. In this race, the Libertarian candidate Betsy Elizabeth Summers drew 3.8% of the vote, potentially enough to swing the decision.

REPUBLICAN CONSOLATION PRIZE: The PA Congressional Delegation

In one of the hottest races nationally, Republican Keith Rothfus took incumbent Mark Critz’ western and southwestern PA congressional seat with 51.5% of the vote. This changes the congressional ratio to 13 Republicans and 5 Democrats in Pennsylvania’s delegation. It was 12R and 7D previously. PA lost one congressional seat through the redistricting process. The US House Democratic delegation from PA does have a more liberal tilt thanks to the 2012 primary defeat of central PA’s centrist Democrat Tim Holden by Democratic candidate Matthew Cartwright who garnered 60.5% of the vote in the general election.

Incumbent Republican Mike Kelly from northwest PA defeated Missa Eaton 54.7% to 41.1% in a hotly contested race. An open seat in south central PA vacated by retiring Republican Todd Platts was retained by the GOP with Scott Perry winning 59.7% over Harry Perkinson (34.5%). Other incumbents won 55% or more of the vote.

GOP KEEPS LEGISLATIVE CONTROL

SENATE…

Senate Republicans lost three open seats to Democrats: Sean Wiley (Erie) over Republican Janet Anderson 60.5% to 39.5%; Matt Smith (Allegheny) over Republican D. Raja 52.7% to 47.3%; and Democrat Rob Teplitz (Dauphin) over John McNally in south central PA 51.6% to 48.4%. Incumbent Senators of both parties won by 55% or better but incumbent Democrat John Wozniak (Cambria) survived a scare by eking out a 51.2% to 48.8% margin over Republican Timothy Houser. Two races thought by some to be close ended up with a strong 57.1% victory by Republican Elder Vogel (Beaver) and incumbent Republican Dave Argall (Schuylkill) with 56.1%. The open GOP seat in Venango County was filled by Republican Scott Hutchinson who was unopposed. The new ratio will be 27 Republicans and 23 Democrats.

Eight Senate incumbents had no opposition from the other party and were unopposed. They were four Democrats Vincent Hughes (Phila.), Jay Costa (Allegheny), James Brewster (Westmoreland/Allegheny), and Shirley Kitchen (Phila.)… and four Republicans: Don White (Indiana), Joe Scarnati (Jefferson), John Gordner (Columbia), and Pat Vance (Cumberland)

HOUSE RESULTS

DEMOCRAT WINS…

Democrats did not lose a single incumbent.
Steven Santarsiero, who won in 2010 by fewer than 300 votes won this time 57.7% over Republican Anne Chapman, a Tea Party favorite who won a bruising Republican primary.
Targeted Westmoreland County incumbent Democrat Joe Markosek won with 54.8%.
Democrats retained the seat held by Erie Rep. Hornaman with a victory by Ryan Bizzaro by 53.8% and Joe Brennan’s (Lehigh/Northampton) seat with a race won by Daniel McNeill (64.6%).
Republican incumbent Tom Quigley (Montgomery) lost to Mark Painter (50.4%).

REPUBLICAN WINS…

Sue Helms (Dauphin) won over Democrat Christopher Dietz 54.5% to 45.5%. Because of a tough primary, Helm had been regarded as vulnerable.
The GOP retained the Erie seat of John Evans via a win by Greg Lucas (55.1%) and the Chester County seat of Curt Schroder via a victory by Becky Corbin (53.6%).
Republican John Taylor survived a Philadelphia Democratic surge by winning 57.4% of the vote.
The seat held by retiring Democrat Bud George (Clearfield) was picked up by Republicans with a victory by Thomas Sankey (60.9%).
Incumbent Warren Kampf (Montgomery) beat former Rep. Paul Drucker again with 51/7%.

UNCERTAIN …

NOTE: Several of the closest races have not been officially called at time of publication.

Incumbent Republican Rep. Justin Simmons (Lehigh) may have lost to Democrat Kevin Deeley 12,841 to 12,674.
Incumbent Republican Nick Micozzie (Delaware) holds a razor thin 12,871 to 12,752 edge over Shaeamus Bonner.
Former Rep. Dave Levdansky has a slight lead over incumbent Rick Saccone 13,937 to 13,873.

95 House races took place where a candidate was unopposed (43 Republicans and 43 Democrats). In nine races, the candidate had secured the nominations from both parties from the following counties: Mercer, Butler, Beaver, Allegheny, Armstrong, Bedford, Lackawanna, Columbia, and Delaware. The political ratio before the election was 109 Republicans, 91 Democrats and three vacancies. Even with democratic pickups, the GOP will still control the House.

There will be two vacancies at the start of the 2013-14 session of the General Assembly. Democratic seats held by Matt Smith (Allegheny), elected to Senator, and Eugene DePasquale (York), elected to Auditor General, will need to have special elections.

REGULATORY NOTE: SANDY NOT CONSIDERED HURRICANE PER REGULATORS

Regulators in several states including Pennsylvania have ruled that insurers may NOT apply a hurricane deductible for claims arising from Sandy’s damages because the storm was downgraded from hurricane status. A hurricane deductible, if applicable, would have subjected property owners to a much higher deductible, a percentage of the structure’s value instead of a flat deductible that must be met.

In addition, PA Insurance Commissioner Michael Consedine convened a conference call November 1 with insurers to present the Department’s view of claims procedures and suggesting that insurance companies exercise leniency when adjusting claims. There is also going to be a data call to determine the scope of insurance claims.

Tags: 2012, 30th Issue November 7, LEG REG REVIEW 2012, Legislative Review, NAHU, PAHU, Phillips Associates, Vince Phillips

LEG REG REVIEW 2012, 29th Issue October 30, 2012

Oct 30

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.

PLEASE VOTE

Next Tuesday is Election Day in the Commonwealth. Make sure that you make your voice heard.

PPACA and PENNSYLVANIA STATUS

Pennsylvania has not completed three major decisions dictated by the Patient Protection Affordable Care Act (PPACA). First is whether or not to expand Medicaid eligibility to 133% of the Federal Poverty Level per the Supreme Court decision which made this a voluntary decision by the states. This decision is important because the Health Insurance Exchange portal envisioned by PPACA also enrolls a person in Medicaid if they meet the income criteria. The second decision is what the minimum essential benefits should be. PA missed the October first deadline but instead Insurance Commissioner Michael Consedine wrote to HHS Secretary Sibelius saying that lack of HHS guidance and no Federal rule-making meant that Pennsylvania could not specify what those minimum essential benefits should be. Minimum Essential Benefits must be known before a Health Insurance Exchange can operate or private sector plans know what their coverage mandates will be in 2014. Decision number three is whether PA will establish a state-based exchange or acquiesce to the Federal Government in a federally-facilitated exchange. Commissioner Consedine wrote HHS seeking answers to 26 questions which are necessary before PA can move along any further with implementation. No replies have been received.

A link to the two Consedine letters is found below.

http://www.portal.state.pa.us/portal/server.pt/community/health_insurance/9189/federal_health_insurance_reform/713453

CROP INSURANCE HIGHLIGHTED AT PDA CONFERENCE

On October 23, the PA Department of Agriculture (PDA) convened its 13^th Annual Crop Insurance Conference in Harrisburg. In addition to presentations about the farm economy and specific topics such as ethanol’s impact on agricultural commodity supply and demand, there were a number of items of key interest to insurance agents specializing in Crop Insurance. Some include:

- If a new Farm Bill passes Congress after the election in the lame duck session, a plus for increasing demand for Crop Insurance will be the end of direct payments to farmers because Crop Insurance will be the major safety net left standing.

- A minus will be de-linking Crop Insurance from direct disaster assistance to farmers in case of catastrophe. In the current Farm Bill, a farmer has Crop Insurance in order to qualify for some types of disaster relief.

- Pennsylvania policy count was 12,829 as of 8/27/12 compared with 12,690 and 12,680 for 2011 and 2010 respectively.

- There was $541 million protection in force in 2011 compared to $390.1 million in 2010 and $386.6 million in 2009. Value of crops insured exceeded $500 million for the first time in 2011. Insured acres increased slightly to about 1.7 million acres in 2011 compared to about 1.5 million in 2010 and 2009.

- Total premium was $66.5 million in 2011 but due to premium subsidies the net premium paid by farmers was $20.8 million. Losses in 2011 paid to farmers were $65.1 million. This payout in 2011 (think floods, Tropical Storm Lee etc.) resulted in a farmer benefit per $1 of premium of $3.13.

CORBETT SIGNS DENTAL INSURANCE BILL INTO LAW

On October 24, Governor Corbett signed Senate Bill 1144 (Ward-R-Westmoreland) into law as Act 186 of 2012. This legislation prevents dental insurers from providing discounts for services not covered by a dental insurance policy. According to the dentists, this amounts to imposing a pricing schedule on dentists that is untenable since the treatments are not covered by the policy. Insurers argued unsuccessfully that SB 1144 means that patients will be disinclined to get the extra services without a discount.

INSURANCE DEPARTMENT ANNOUNCES AIG SETTLEMENT

The PA Insurance Department announced that AIG is the latest major national insurer to settle a multi-state enforcement action where AIG agreed to be more diligent in locating life insurance beneficiaries using the Social Security Administration’s Death Master File. The settlement amounts to $11 million to be divided between those states participating in this settlement agreement. Earlier, Nationwide, MetLife and Prudential had agreed to similar terms. Details: Melissa Fox 717/787-3289

‘WHAT’S HOT’ PROFILES OPEN ENROLLMENT

The Insurance Department has produced a consumer document meant to guide them through health insurance open enrollment strategies. It presents guidance on deductibles, comparing lists of hospitals and health care providers, etc. BUT does not reference the role of a licensed insurance professional in assisting consumers in weighing their options. Link:

http://www.ins.state.pa.us/portal/server.pt/community/insurance_department/4679

REGULATORY UPDATE

The MCARE surcharge for doctors and hospitals for calendar year 2013 has been published. Notice 2012-7 specifies that the assessment is 25% of the “prevailing primary premium”, the schedule of occurrence rates approved by the Commissioner for the Joint Underwriting Association (JUA), the medical malpractice insurer of last resort.
Domestic stock casualty company Rayant Insurance Co. of PA has filed a request to surrender its Pennsylvania certificate of authority.
Mine subsidence insurance rates were reduced by 15% and the commercial structure rate by more than 50%. Mine subsidence insurance is a PA government program administered by DEP and is available through licensed property agents per a 2002 law. Information on location coverage desirability is available at www.paMSI.org or 800/922-1678

WORKERS COMPENSATION NEWS

DELAWARE: The Delaware Insurance Department is convening hearings on a proposed 43.53 percent increase in the loss cost filing for Residual Market and an overall increase of 38.27 percent in collectible loss costs for the voluntary market in that state, not considering a Chancery Court decision. The Court had required mandatory mandated reductions from 2008-2011. Filed by the Delaware Compensation Rating Bureau (DCRB), the new schedule would take effect December 1, 2012 if approved by the Department. Details: DCRB and Circular 876 (the filing). http://www.dcrb.com/shared/d_contents.htm The DE Insurance Department has hearings scheduled for November 13 in Dover and November 17 in Wilmington. Details: 302/674-7300 or http://www.delawareinsurance.gov/information/PubInfoSession_DCRB.pdf .

PENNSYLVANIA: The PA Compensation Rating Bureau has updated its Manual filing for Professional Employer Organizations (PEOs) and their small business clients via Circular 1606 effective January 1, 2013. PEO legislation was enacted by the General Assembly and signed into law by Governor Corbett as Act 102 of 2012 (House Bill 1055). http://www.dcrb.com/shared/p_contents.htm The filing also includes PEO extension endorsements and multiple coordinated policy endorsement.

Tags: 2012, 29th Issue October 30, GPAHU, LEG REG REVIEW 2012, Legislative Review, NAHU, PAHU, Phillips Associates, Vince Phillips

LEG REG REVIEW 2012, 28th Issue October 22, 2012

Oct 23

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.

GENERAL ASSEMBLY CONCLUDES THE SESSION

The 2011-12 session of the PA General Assembly ended with a spate of activity in both chambers as the legislature ended its legislative activities. Although on the calendar to return briefly in November, this is the end of formal legislative activity. Insurance legislation to note:

Going to the Governor is Senate Bill 1144 (Kim Ward (R-Westmoreland), legislation which prevents dental insurers from providing discounts for services not covered by a dental insurance policy. According to the dentists, this amounts to imposing a pricing schedule on dentists that is untenable since the treatments are not covered by the policy. Insurers argued unsuccessfully that SB 1144 means that patients will be disinclined to get the extra services without a discount. The final House vote was 197-0.
Senate Bill 201 (Rafferty-R-Montgomery), a parity measure designed to ensure equal treatment, conditions etc. by insurers for retail pharmacies versus mail-order pharmacies. Long sought by the pharmacists who maintain that insurance carriers created disincentives for consumers to choose a neighborhood drug store over a mail-order operation, the measure headed to Governor Corbett for his signature after a 191-0 House vote. It is a compromise version of HB 511 which was considered earlier in the session. HB 511 was tabled in the House on July 2.

Two other insurance bills failed to pass the House, running out of time at the end of the session. First was Senate Bill 1591 (Folmer-R-Lebanon). A priority for the Insurance Department, this bill would have ended a data requirement for medical liability insurance companies to provide extensive annual data reports on claims, etc. The Department and insurers felt that this was an administrative time-consuming task with limited value to regulators or consumers. This mandate goes back to the medical malpractice insurance (MCARE) law passed by the General Assembly in 2002.

A second bill needing but not receiving final House passage was House Bill 272 (Hess-R-Bedford), establishing an education program for Lyme disease within the Department of Health. At issue during its legislative life was whether insurance companies would be mandated to provide coverage for Lyme disease, something opposed by the insurance industry. It passed the Senate October 17 49-0 and was in the House Rules Committee at session’s end. A companion bill was Senate Bill 210 (Greenleaf-R-Montgomery) which also died.

Also not surviving the session was Senate Bill 1391 (McIlhinney-R-Bucks) which passed the Senate & Banking Committee October 17. This legislation restricts health insurers from setting co-pays or coinsurance for non-physician services to no more than the co-pay or coinsurance for a primary care provider appointment.

OTHER LEGISLATION

Senate Bill 1352 (Gordner-R-Columbia) amends 1994’s Act 14 to require insurers to treat speech pathologists, licensed audiologists and teachers of the hearing impaired as ‘health service doctors’, thus qualifying them for insurer payment. SB 1352 was reported out of the Senate Banking & Insurance Committee and passed the Senate 49-0 on October 2. It was referred to the House Professional Licensure Committee.

HB 2467 (Micozzie-R-Delaware) went to the Governor October 18. It provides for vehicle ownership transfer to auto dealers with the ability to sell a new vehicle from having the manufacturer statement of origin if it obtains the applicable powers of attorney to execute a transfer. It also says that certificates of salvage sought by insurance companies do not need to be notarized if there is an assignment of title to the insurer.
Three banking bills went to the Governor for his signature. They are:

- HB 2368 which expands on the duties of the Banking and Securities Department

- HB 2369 expands the Banking and Securities Department authority

- HB 2370 clarifies mortgage companies’ authority in charging the maximum allowable interest rate permitted by law.

REGULATORY UPDATES

Secretary of Health Eli Avila resigned his position within the Corbett Administration in order to be closer to his family who remained in New York State while he worked here in Harrisburg. During his tenure, he received criticism on his tirade against a local restaurant for serving an egg sandwich not up to the Secretary’s standards and his purchase of Health Department blazers which the media criticized as being a waste of taxpayer money. The Department’s Executive Deputy Secretary Michael Wolf is serving as Acting Secretary.
The reorganization is official with the Banking Department now being called the PA Department of Banking and Securities. Secretary of the Cabinet office remains Glenn Moyer, the Banking Secretary. Amiee Toth is the Department’s Deputy Secretary for Securities.
The PA Insurance Department announced a settlement with Nationwide Life Insurance Company where the company will augment its efforts to locate beneficiaries of death awards by using the Social Security Administration’s Death Master file. Nationally, Nationwide was required to pay $7.2 million to all of the states where it had entered into a settlement.

SEPTEMBER COLLECTIONS ARE UP

PA collected $2.4 billion in revenues in September 2012 which was $43.9 million (1.8%) more than expected. Exceeded expectations were seen in almost all taxation categories (personal income tax, corporate, “sin taxes”, etc.) except for inheritance taxes and real estate transfer taxes. Motor vehicle tax receipts were also down. From a budgeting point of view, the Governor and lawmakers next year may take some comfort with these numbers where August and September both showed stronger than anticipated revenues versus the gloomier results earlier. Year to date collections are $6.1 billion or $10.7 million (0.2%) over estimates. The less than expected showing in real estate transfer taxes point to a continuing weakness in that sector and the drop in motor vehicle revenues may reflect higher gas prices and more consumer reluctance to incur that expense.

NEWS AND NOTES

According to Judicial Hellholes, Philadelphia may lose its ranking as a Judicial Hellhole because of “much needed reforms imposed earlier this year by an administrative judge which have dramatically reduced the explosive growth in recent years of new mass tort filings here.”
Medicare Open Enrollment began October 15 and runs until December 7. Centers for Medicare Medicaid Services issued its guide to help people prepare for making those choices. Changes in 2013 are coverage for certain preventive care treatments and services to bring Medicare more in line with the mandated benefit changes from the Patient Protection Affordable Care Act (PPACA). The donut hole in Part D is shrinking thanks in part to a PPACA tax on brand name pharmaceuticals. Subscribers will pay 47.5% for brand name drugs versus 50% before and 79% for generic drugs (86% before). A link to Medicare Plan Finder is found at the following.

http://blog.medicare.gov/2012/10/01/put-it-on-your-fall-checklist-medicare-open-enrollment/

Tags: 2012, 28th Issue October 22, GPAHU, LEG REG REVIEW 2012, Legislative Review, NAHU, PAHU, Phillips Associates, Vince Phillips

LEG REG REVIEW 2012, 27th Issue September 24, 2012

Sep 27

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.

CONSEDINE CRITICIZES HHS HANDLING OF STATE EXCHANGE

Testifying in Washington before a congressional panel, PA Insurance Commissioner Michael Consedine spoke to the inadequacies of guidance from the US Department of Health and Human Services (HHS) in helping states implement Health Insurance Exchanges. Because of this lack, Pennsylvania has not progressed sufficiently in meeting HHS’ deadlines to show significant progress before PA could have a State Exchange (Deadline is November 16.) This follows up on Consedine’s August 23 letter to HHS Secretary Sibelius where he listed 26 key points needing clarification. Chances for PA to have its own Exchange appear to be fading quickly since no implementation legislation has been introduced by majority Republicans in House and Senate. Governor Corbett has not come out with any tangible proposal since a conjectural draft of legislation was presented to stakeholders back in February.

Commissioner Consedine said “We still lack clear direction and flexibility promised states has not materialized, something that at this point poses a significant barrier to our ability to make informed decisions.” He also noted that HHS had not responded to his August letter. Consedine is the featured speaker at GPAHU’s October 4 annual meeting (www.gpahu.net). A link to his testimony and August letter appear below.

http://waysandmeans.house.gov/uploadedfiles/consedine_testimony_final_hl912.pdf

AGENTS SCORE re COMMISSIONS AND MLR

Insurance agents scored an important victory in the US House when HR 1206 was reported out of the House Energy & Commerce Committee September 20 by a 26-14 voice vote. This bill would exempt agent compensation from the non-claims portion of the Medical Loss Ratio (MLR) mandated by the Patient Protection Affordable Care Act (PPACA). Because HHS ruled agent compensation to be the part of non-claims (15 or 20% depending on group size), some companies have slashed commissions since they were discretionary expenditures. PA Rep. Joe Pitts chairs the Health subcommittee which had jurisdiction over the bill which now goes to the full House to be potentially voted on after the election recess. HR 1206 has 212 sponsors including a majority of the PA House delegation.

KISSINGER PROMOTED TO GOVERNOR’S STAFF

Kari Kissinger is the new deputy secretary of legislative affairs for Governor Corbett, leaving her position as legislative liaison for the PA Insurance Department, a post which she has had since the start of this Administration. Previously, she worked at IA&B in government affairs.

NATIONAL NOTE: POLITICS OR POLICY?

The Obama Administration is emphasizing the contributions PPACA has made to improve the health well-being for seniors on Medicare. On September 21, HHS issued a statement saying that on average, Medicare recipients on the traditional plan will have saved $5,000 by 2022 and those with high Rx costs will save $18,000 by 2022. This follows a September 19 release saying that Medicare Advantage remains strong with a projected 11% increase in enrollment next year, presumably to counter Republican attacks that PPACA has weakened Medicare by diverting Medicare Advantage dollars to fund other parts of PPACA.

REGULATORY UPDATES

Aetna filed papers with the Insurance Department seeking control of Coventry Health Care of PA, Inc., HealthAssurance PA Inc. and HealthAmerica PA Inc.
On September 18, the PA Compensation Rating Bureau issued Circular 1605 making manual revisions in a number of classification codes which would be effective April 1, 2013. Among the changes is a new class Code 802 Mobile Crane Rental with Operators which was broken out of Code 811. The Bulletin also says that 802 does not cover renting or leasing of cranes without operators (Code 814) and rigging contractors should be under Code 657. For a full list of changes, please refer to www.pcrb.com.
National Indemnity Company has filed an application to acquire domestic stock casualty Amguard Insurance Company, Eastguard Insurance Company, and Westguard Insurance Company.

LEGISLATIVE SCHEDULE BEGINS TO REV UP

Back September 24, the General Assembly resumes its work in Harrisburg but prospects for significant work on insurance, business or tort issues are confronted by the lack of session days in this session. Awaiting consideration are House Bill 42 (Baker-R-Tioga) which challenges PPACA on the individual mandate and Senate Bill 10 (Scarnati-R-Jefferson) which would amend PA’s constitution to prohibit the individual mandate. Regardless of ideology, the real arbiter of whether these bills see action is a list of about 100 bills that could see action balanced against very few session days left.

Several bills are poised for possible action where most of the preliminary work was done before the summer recess. Senate Bill 9 prohibiting granting of state benefits to most illegals was last reported on concurrence by the House. All it needs is Senate concurrence with House amendments to send it to the Governor for his signature. Another concurrence measure is Senate Bill 351 (Baker-R-Luzerne), a tort reform bill that gives civil immunity for Good Samaritan care provided by non-medical personnel re some emergency situations. House Bill 532 (Saylor-R-York) is on the active Senate calendar. It mandates dental insurance coverage for anesthesia in certain necessary situations such as for a mentally disabled youth

Senate Bill 5 which establishes a state support system for free clinics has been tabled in the House but could be resurrected quickly. Another tabled bill is House Bill 1144 (Micozzie-R-Delaware) back from the Senate. It prohibits insurer practices regarding non-covered medical services and procedures.

There are no insurance bills on the active House calendar.

INSURANCE COMMITTEE ACTIVITY

On the committee horizon is House Bill 2299 (Cutler-R-Lancaster) which amends the MCARE law to limit some medical professional liability in emergency care situations. This bill is scheduled for a House Insurance Committee hearing on October 16.

The Senate Banking & Insurance Committee concluded a hearing last week on so-called payday lending practices. Next up is a meeting September 26 to consider several bills, all but one of which are banking rather than insurance bills. The insurance bill is Senate Bill 1591 (Folmer-R-Lebanon) which would delete section 743 of the MCARE law (mandatory medical malpractice insurers reports required to be submitted to the Insurance Department). Banking bills include:

- House Bills 2159, 2369, 2370 on various aspects of banking regulation

- House Bill 2485 (Grell-R-Cumberland) regarding electronic funds transfers

Tags: 2012, 27th Issue September 24, GPAHU, LEG REG REVIEW 2012, Legislative Review, NAHU, PAHU, Phillips Associates, Vince Phillips

LEG REG REVIEW 2012, 26th Issue September 9, 2012

Sep 10

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.

GENERAL ASSEMBLY HAS VERY FEW DAYS LEFT

The PA General Assembly has few session days with which to complete its work on a host of issues ranging from liquor store privatization to property tax reform to health insurance exchange legislation, etc. All four caucuses said that they do not want to come back after the election but the House put some November days on the schedule “just in case”. Another issue may re-surface. Appropriations Committee Minority Chairman Joe Markosek (D-Westmoreland) announced September 5th that he plans to introduce a ban on cell phone or other hand-held electronic device use while driving. Current law prohibits texting while driving but enforcement may be difficult since it is not always easy for law enforcement to determine the phone’s actual use.

Senate House

September 24,25 24,25

October 1,2,3,15,16,17 1,2,3,4,15,16,17,18

November 14 (to elect leaders) 13, 14, 19, 20

STATE BUDGET UPDATE

$1.8 billion in August revenues to the Commonwealth were $32.8 million or 1.8 percent less than expected. The fiscal year-to-date shortfall is $33.2 million or .9 percent off. The consequence of these numbers if they continue to show less money coming in than projected may be a forced cutback in current state spending. July’s collections were $100 million more than anticipated.

FEDERAL HEALTH CARE LAW IMPLEMENTATION

The Federal Government has issued several pieces of guidance and direction regarding the implementation of the Patient Protection Affordable Care Act (PPACA). First was an HHS Intergovernmental and External Affairs Notification that presented states with a check list of items to be completed by November 16, 2012 if the state plans to have a state Exchange or wants to have a Partnership Exchange where the state administers HHS’ Exchange design. The checklist is over 30 pages. http://www.cciio.cms.gov/resources/files/hie-blueprint-081312.pdf

Number two is IRS Notice 2012-58 describing safe harbor methods employers may use to determine which employees are treated as full-time employees and specifically for newly hired employees. It provides a one year look-back to see if variable employees are seasonal or included as full-time. This is important for employers wanting to see if they are required to provide insurance under PPACA if they have 50 or more full-time employees. Full-time is defined as employed on average at least 30 hours of service per week. The Notice also discusses rules surrounding a provision in the law that waiting periods may not exceed 90 days.

Notice 2012-58 expands on Notice 2011-38 (look-back period) and Notice 2012-17 (full-time status). This Notice also builds on Notice 2011-73 which says that an employer may use the employee’s W-2 if household income is unknown when calculating the 9.5% percent of household income (If an employee’s contribution to a health plan exceeds 9.5% and is eligible and enrolled in a state Exchange, the employer is fined $3000 for each employee after the first 30 employees are exempted.)

Number three is a private letter sent to national gay/lesbian/transgender groups by HHS Secretary Sibelius stating that it would be discriminatory for health plans or employers to discriminate against transgender people. Doing so per the letter amounts to sexual discrimination under PPACA and can result in EEOC enforcement action to the insurer and/or the employer. Self insured plans may still have the option of not covering transgender people and individual plans up until 2014. Per the HHS, this does not mean that plans must cover surgery to change genders. This letter was sent July 12 but became public in a September 3 Washington Post article.

POLITICAL NOTES

Rep. Joe Brennan (D-Lehigh) removed his name from the ballot because of an arrest. Former Whitehall Township Commissioner Daniel McNeill was named to replace Brennan on the ballot.
Replacing John Bear (R-Lancaster) on the November Republican ballot is Area Central American Relief Effort president Steven Mentzer.
Replacing newly elected Senator Vulakovich on the ballot in Allegheny County as Republican candidate for the General Assembly is attorney Hal English.
At the Democratic Convention in Charlotte, NC, several Pennsylvanians had roles. Speaking were Philadelphia Mayor Nutter, Rep. Allyson Schwartz, and Senator Casey. One PA congressmen opted not to attend. Mark Critz stayed home to campaign.

REGULATORY UPDATES

On August 29, the PA Insurance Department announced an updated Highmark filing relative to its change of control and acquisition of West Penn Allegheny Health System. Details: www.insurance.pa.gov
A State Board of Medicine regulation went into effect August 25. Among other things, it states that nurse mid-wives must carry professional liability insurance unless they are a federal employee or do not provide actual medical care. An interim limited license for those in a graduate medical program who practice outside the purview of their graduate work also requires proof of professional liability insurance. Details: Teresa Lazo, State Board of Medicine 717/783-7200
Mount Vernon Specialty Insurance Company has applied for a Certificate of Authority to operate as a stock casualty company in PA.
The Patient Safety Committee established by MCARE legislation is meeting in Harrisburg Sept. 11. Details: 717/346-0469

SPARKS BEGINS 2012 SCHEDULE

The SPARKS Club Clinics schedule for September 2012 has been released. This series of four-credit courses is supported by Mutual Insurance Companies. Topics this year include Identity Theft, Insurance Liability with Social Media, and E&O/Compliance. Details: www.sparksclub.com

Monday Sept. 10 Dover, DE Monday Sept. 24 Bethlehem

Tuesday September 11 Lancaster Tuesday Sept. 25 Williamsport

Wednesday Sept. 12 Grantville Wednesday Sept. 26 Wilkes-Barre

Thursday Sept. 13 Warrendale Friday Sept. 28 Kennett Square

Friday Sept. 14 Altoona

*******

Celebrate in September! It is Life Insurance Awareness Month. Prepare for disasters in September! It is National Preparedness Month with details at www.ready.gov or readypa.org.

Tags: 2012, 26th Issue September 9, GPAHU, LEG REG REVIEW 2012, NAHU, PAHU, Phillips Associates, Vince Phillips

Posts Tagged 2012

LEG REG REVIEW 2012, 35th Issue December 27, 2012

LEG REG REVIEW 2012, 34th Issue December 17, 2012

LEG REG REVIEW 2012, 33d Issue December 3, 2012

LEG REG REVIEW 2012, 32d Issue November 26, 2012

LEG REG REVIEW 2012, 31st Issue November 12, 2012

LEG REG REVIEW 2012, 30th Issue November 7, 2012

LEG REG REVIEW 2012, 29th Issue October 30, 2012

LEG REG REVIEW 2012, 28th Issue October 22, 2012

LEG REG REVIEW 2012, 27th Issue September 24, 2012

LEG REG REVIEW 2012, 26th Issue September 9, 2012

GPAHU 13th Annual Golf Outing

Recent Posts

Health Care Links

Archives

NAHU News

Kaiser Family Foundation News

Benefactors

Meta

Website design by RavenWood Creative.