Posts Tagged Risk Pool

LEG REG REVIEW 2011, 4th Issue January 24, 2011

Jan 25

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.

INSURANCE COMMITTEE MEMBERS NAMED

Both the House and Senate have finalized their membership list for the committees which oversee insurance and financial services. In the Senate, the Senate Banking & Insurance Committee handles both banks and insurance while the House has split responsibilities between Insurance and Commerce Committees. Republicans are the Majority Chairs in both House and Senate.

SENATE BANKING & INSURANCE COMMITTEE

Republicans

Chairman Don White (Indiana)

Members: Kim Ward (Luzerne); Pat Browne (Lehigh); Jake Corman (Centre); Jane Earl (Erie); Stewart Greenleaf (Montgomery); Tom Rafferty (Montgomery); Pat Vance (Cumberland)

Democrats

Chairman Mike Stack (Phila.)

Members: Lisa Boscola (Northampton); Larry Farnese (Phila.); Christine Tartaglione (Phila.); Anthony Williams (Phila.)

HOUSE INSURANCE COMMITTEE

Republicans

Chairman Nicholas Micozzie (Delaware)

Members: Scott Boyd (Lancaster); Gary Day (Berks); Bob Godshall (Montgomery); Glen Grell (Cumberland); Seth Grove (York); C. Adam Harris (Juniata); Tom Killion (Delaware); Marguerite Quinn (Bucks); Brad Roae (Crawford); Curt Schroder (Chester); Justin Simmons (Lehigh); Curtis Sonney (Erie); Mike Tobash (Schuylkill); Katherine Watson (Bucks)

Democrats

Chairman Tony DeLuca (Allegheny)

Members: Bryan Barbin (Cambria); Brendan Boyle (Montgomery); Dom Costa (Allegheny); Florinda Fabrezio (Erie); Nick Kotik (Allegheny); Robert Matzie (Allegheny/Beaver); Eddie Day Pashinsky (Luzerne); Josh Shapiro (Montgomery); Matthew Smith (Allegheny)

Those more focused on financial services than insurance will note that the two House Commerce Committee Chairs are unchanged except that the Republicans are now in charge of that committee. Majority Chair is Dick Hess (Bedford) and Minority Chair is Peter Daley (Fayette). Other committees of interest to those in the Workers’ Compensation insurance market are the Senate Labor & Industry Committee chaired by John Gordner (Columbia) for the Republicans and Christine Tartaglione (Phila.) as Democratic (Minority) Chair. The House Labor Relations Committee is chaired by Republican Ron Miller (York) and Democrat (Minority) Bill Keller (Phila.)

Those interested in Crop Insurance will take note that both the Majority and Minority Chairs of the Senate Agriculture & Rural Affairs have changed with former Chair Mike Brubaker becoming Finance Committee Chair and the death of former Senator Michael O’Pake on the Democratic side. New Chairs are Senator Elder Vogel (R-Lawrence) and Minority Chairman Lisa Boscola (D-Northampton). House Agriculture & Rural Affairs Committee Majority Chair is Rep. John Maher (R-Allegheny/Washington) while the new Minority Chair is Rep. Joseph Petrarca (D-Westmoreland).

RENDELL COMMITTEE ISSUES FINAL EXCHANGE REPORT

The Rendell Administration committee tasked with developing recommendations on how to implement parts of the Patient Protection Affordable Care Act in Pennsylvania has done so. These suggestions are not binding on the Corbett Administration. Link to text follows below:

http://mail.aol.com/33069-111/aol-1/en-us/mail/get-attachment.aspx?uid=1.30944505&folder=NewMail&partId=4&saveAs=Health%2520Care%2520Reform%2520Implementation%5b1%5d.pdf

CORBETT ADMINISTRATION UPDATE

Guy Ciarrocchi, 46, will serve as Chief of Staff to Lieutenant Governor Jim Cawley. Ciarrocchi was Executive Director of the PA Coalition of Public Charter Schools and previously was PA U.S. Rep. Jim Gerlach’s (R-6^th) Chief of Staff.
Another Deputy Chief of Staff is Luke Bernstein, who had previously worked for former U.S. Senator Rick Santorum.

CORRECTION: Last week’s Leg Reg Review posted Andrew Dinniman as hailing from Delaware County. He of course actually represents constituents in Chester and Montgomery Counties.

GENERAL ASSEMBLY UPDATES SESSION SCHEDULE for First Half 2011

January 24, 25, 26

February 7, 8, 9, 14, 15, 16, 28

March 1, 2, 7, 8, 9

April (4 House only) 5, 6, 11, 12, 13, (25 House non-voting) 26, 27

May 2, 3, 4, 9, 10, 11, 23, 24, (25 House only)

June 6, 7, 8, 13, 14, 15, 20, 21, 22, 23, 24, 27, 28, 29, 30

ITEMS TO NOTE

· The vote last week by congressional House Republicans to repeal the Patient Protection Affordable Care Act (PPACA) went according to party lines per the vote by the Pennsylvania delegation to the U.S. House. All PA Democrats voted against repealing it including two who had voted against original passage, Jason Altmire from Allegheny County and Tim Holden from central PA. All Republican Members of Congress voted for repeal.

· NAHU convenes national Capitol Conference for health insurance brokers to discuss PPACA and other reform issues in Washington, DC February 13-16. In addition to legislative appointments, there are a number of workshops on the Exchanges and other current topics. Details; www.nahu.org

Tags: 11th Issue, Excess and Surplus Lines, GPAHU, Healthcare Reform, IRRC, Joan Troutman, LEG REG REVIEW 2010, MASCPA, NAHU, Risk Pool, Vince Phillips

LEG REG REVIEW 2011, 3d Issue January 17, 2011

Jan 19

Posted by GPAHUAdmin in Legislative | No Comments

INSURANCE COMMISSIONER DESIGNATED BY CORBETT

Governor Corbett has tapped Harrisburg attorney Michael F. Consedine to be his Insurance Commissioner. A senior insurance attorney for Saul Ewing, Consedine has specialized in a number of insurance areas with particular focus on Pennsylvania’s Mutual Insurance Companies (property casualty) and his representation of “a major central Pennsylvania health insurer in raising anticompetitive and legal objections to the proposed merger of two other dominant Pennsylvania health insurers” (source: www.saul.com/attorneys/bio.aspx?attID=410 )

Prior to joining Saul Ewing, Consedine saw government service during the Ridge Administration as Insurance Department Counsel. Among the areas on which he worked was the legal work connected with Act 40, the statute regulating how banks may sell insurance, and Act 154, the legislation designed to prevent “churning” by life insurance companies. He was also a member of Corbett’s Transition Team. His nomination requires Senate confirmation. Once confirmed, he will succeed Acting Commissioner Robert Pratter.

CORBETT ADMINISTRATION UPDATE

A number of other Corbett choices have also been made. Cabinet appointments require Senate confirmation.

Another Saul Ewing attorney, Steve Aichele of Chester County, will be General Counsel to the Administration.
Department of Education Secretary pick is Ron Tomalis, a former U.S. Department of Education official.
PennDOT Secretary will be Barry Schoch who currently is vice president for transportation company McCormick Taylor in central PA and is President of the PA Highway Information Association.
Inspector General will be Kenya Mann Faulkner, a partner in the Philadelphia law firm of Ballard Spahr.
Secretary of the Commonwealth will be Carol Aichele. She is now a Chester County Commissioner and is married to fellow appointee Steve.
Glenn Cannon will direct PA Emergency Management Agency (PEMA). He worked for FEMA and Hillard Heintze Strategic Security Advisors.
DEP Secretary will be Mike Krancer, a Bryn Mawr attorney who has served under Governors of both political parties as a judge of the Environmental Hearing Board
Gary Alexander, Rhode Island’s former Secretary of Health & Human Services will head the Department of Public Welfare.
Department of Revenue will be headed by Dan Meuser, President of Pride Mobility Products.

In addition, Todd Shamash, Senior Counsel and Director of Governmental Affairs at Jefferson Health System is one of Governor Corbett’s Deputy Chiefs of Staff.

LEGISLATIVE STAFF MOVE TO ADMINISTRATION

Two senior legislative aides are taking up positions within the Corbett Administration. Andrew Ritter, formerly Executive Director of the House GOP Policy Committee, becomes Deputy Secretary of Legislative Affairs while former Senate Environmental Resources & Energy Committee Executive Director Pat Henderson will be the Administration’s point person on energy issues.

SURCHARGE EXPLANATION

Former Rep. Roy Reinard (R-Bucks) contacted Leg Reg Review to explain that the surcharge prohibition threshold increase noted in Leg Reg Review of January 10 “is in excess of one’s deductible so the new limit of $1,450.00 is added to a deductible to make one’s individual limit.” Former Rep. Reinard was the author of the original legislation establishing the surcharge restriction.

FEDERAL FINANCIAL SERVICES COMPLAINT DATA BASE ANNOUNCED

Under interim authority granted by the Dodd-Frank Act, the U.S. Treasury Department has issued a Notice with a detailed description of the complaint database that will be used by the new Consumer Financial Protection Bureau (CFPB) Implementation Team. The database provides a record of consumer complaints against the financial services industry and will be used as a resource record for use by agencies, the U.S. Department of Justice and/or courts. Comments on the Notice, which can be found here, are due on Feb. 9.

LEGISLATIVE POLITICAL MOVES

Two veteran legislators are reportedly seeking other political office. Republican Kate Harper (Montgomery) may be seeking the GOP nomination for Montgomery County Commissioner while Democrat Chelsea Wagner (Allegheny) may run for the Democratic nomination for Allegheny County Controller.

SENATE COMMITTEE CHAIRS NAMED

Committee	Republican (Majority) Chair	Democrat (Minority) Chair
Aging & Youth	Kim Ward (Westmoreland)	LeAnna Washington (Phila.)
Agriculture & Rural Affairs	Elder Vogel (Lawrence)	Lisa Boscola (Northampton)
Appropriations	Jake Corman (Centre)	Vincent Hughes (Phila.)
Banking & Insurance	Don White (Indiana)	Mike Stack (Phila.)
Communications & Technology	Mike Folmer (Lebanon)	Larry Farnese (Phila.)
Community, Econ & Rec. Dev.	Jane Earll (Erie)	Wayne Fontana (Allegheny)
Consumer Protection Prof. Lic.	Tommy Tomlinson Bucks)	Lisa Boscola (Northampton)
Education	Jeff Piccola (Dauphin)	Andrew Dinniman (Delaware.)
Envir. Resources & Energy	Mary Jo White (Venango)	John Yudichak (Luzerne)
Finance	Mike Brubaker (Lancaster)	John Wozniak (Cambria)
Game & Fisheries	Richard Alloway (Franklin)	Richard Kasunic (Fayette)
Inter-Gov. Operations	Lloyd Smucker (Lancaster)	John Blake (Lackawanna)
Judiciary	Stewart Greenleaf (Mont.)	Daylin Leach (Mont.)
Labor & Industry	John Gordner (Columbia)	Christine Tartaglione (Phila.)
Law & Justice	John Pippy (Allegheny)	Jim Ferlo (Allegheny)
Local Government	John Eichelberger (Blair)	John Blake (Lackawanna)
Public Health & Welfare	Pat Vance (Cumberland)	Shirley Kitchen (Phila.)
Rules	Dominic Pileggi (Delaware)	Jay Costa (Allegheny)
State Government	Chuck McIlhinney (Bucks)	Anthony Williams (Phila.)
Transportation	John Rafferty (Mont.)	John Wozniak (Cambria)
Urban Affairs & Housing	Eugene Yaw (Lycoming)	Jim Brewster (Westmoreland.)
Veterans & Emergency Prep.	Lisa Baker (Luzerne)	Tim Solobay (Washington)

Tags: 11th Issue, Excess and Surplus Lines, Healthcare Reform, Joan Troutman, LEG REG REVIEW 2010, Legislative Review, MASCPA, NAHU, PAHU, Phillips Associates, REGULATORY UPDATE, Risk Pool, Vince Phillips

LEG REG REVIEW 2011, 2d Issue January 10, 2011

Jan 12

Posted by GPAHUAdmin in Legislative | No Comments

GENERAL ASSEMBLY SWORN IN

On January 4, the 2011-12 session of the PA General Assembly officially began with the swearing in of members and election of Rep. Sam Smith as House Speaker and Joseph Scarnati as Senate President Pro Tempore. Another development marking a huge change for the Senate is the retirement January 6 of Steve MacNett, the long-tenured counsel who guided the Senate for decades.

One other development marking the early days of the new Senate session is the date of March 15 to fill the vacancy created by the untimely December death of Senator Michael O’Pake (D-Berks). Neither party has selected their nominee as of this writing. O’Pake’s term would have run through 2012.

Senate Republicans also picked majority committee chairmen for the new session. Leg Reg Review will print the complete list when the Senate Democrats finalize their selection. Some key Republican changes are the move of Agriculture & Rural Affairs chair Mike Brubaker to chair the Finance Committee. New Agriculture & Rural Affairs chair is Elder Vogel (Westmoreland). A new committee was established, Inter-Governmental Affairs to be chaired by Lloyd Smucker from Lancaster County.

CORBETT ADMINISTRATION UPDATE

Tapped as Secretary of Health is New Yorker Eli Avila who is now Suffolk County Chief Deputy Commissioner Dept. of Health Services where he oversees a staff of more than 1,600 and an annual budget of more than $400 million. This requires Senate confirmation.
Chief of Staff will be William F. Ward from Pittsburgh law office Ward McGough, LLC. He had previously worked for Tom Corbett in the Attorney General’s office, the state’s Probation Board, and Solicitor of the Pittsburgh Citizen Police Review Board. This does not need legislative approval.

NONDISCRIMINATION Section 105(h) RULE DELAYED

Per Notice 2011-1, the IRS announced that it is not going to force compliance with the provision of the Patient Protection Affordable Care Act that prohibits discrimination in favor of highly compensated individuals right now pending further guidance on how to comply from the agency. This provision was effective for new plan years after September 23, 2010 for non-grandfathered plans but is now on hold. IRS had earlier issued Notice 2010-63 requesting public comments on how 105(h) could be implemented.

In the new Notice, the IRS asked for additional public comments on:

- Whether the rate of employer contributions should be tested as a nondiscriminatory benefit

- Whether application of nondiscrimination standards should be conducted on a geographic basis

- What should a potential ‘safe harbor’ plan design look like

Comments are due by March 11, 2011 either in writing or by e-mail. Please refer to this link the Notice for the IRS text and details on how to submit comments.

DEP ISSUES MINE SUBSIDENCE and MINE SUBSIDENCE INSURANCE STUDY

On January 4, Department of Environmental Protection (DEP) issued a University of Pittsburgh report documenting mine subsidence from 2003-2008 over ten SW PA counties going as far as Indiana and Cambria Counties. It showed 1,247 “effects” or mine subsidence incidents reported to DEP, a 14 percent increase over the previous five-year reporting period with most centered in Greene and Washington Counties. There are only 58,000 policies in force out of an estimated one million homes potentially affected by mine subsidence. Insurance agents are able to market mine subsidence insurance due to a 2002 law. Details: 717/787-1323

REVENUE PICTURE IMPROVES AT BUDGET HALF-WAY MARK

Current doom and gloom over the Budget is tempered somewhat by revenue numbers which have picked up slightly over projections. January 3, 2011 Revenue Department numbers for December showed a 1.7 percent year-to-date collection over projections. This marks the half-way point in the state’s fiscal year with $11.5 billion collected so far. This is the first time since 2007 that half-year receipts exceeded estimates but falls short of the needed $28 billion or so needed to balance the Budget for this FY. Corporate taxes for December were above estimate by 8.1%; Sales tax was 4.9% over estimate; Personal Income Tax for December was 12.2% over estimate. Other taxing categories: Inheritance taxes were over estimate but real estate transfer tax collections continued to be below projections year to date despite a slight increase over estimate in December.

REGULATORY UPDATE

The PA Insurance Department has increased the Accident Surcharge Dollar threshold to $1,450.00 per Notice 2011-01. This threshold is revised at least once every three years. The old cap of $1,350.00 was effective July 1, 2008. This means that effective July 1, 2011, an insurer will not by law penalize their policyholders by cancelling or imposing a surcharge on a personal automobile policy where an accident has occurred with damages less than $1,450.00.
The PA Health Care Cost Containment Council (PHC4) is meeting January 13. Details: 717/232-6787
The PA Bulletin for January 1, 2011 (Vol. 41, No. 1) Part II contains an index of 2010 Notices issued by the Insurance Department, Banking Department, and other state agencies sorted by topic.
PA Department of Transportation issued a correction to a regulation previously issued October 9 relevant to denial of a driver’s license due to medical, vision, and mental standards. Details: www.pabulletin.com

WINTER DRIVING HOME REMEDIES (Courtesy of PA Moving & Storage Associates)

- Keep your headlights clear with car wax Just wipe ordinary car wax on your

headlights. It contains special water repellents that will prevent that messy mixture

from accumulating on your lights – lasts 6 weeks.

- Squeak-proof your wipers with rubbing alcohol Wipe wipers with a cloth

saturated with rubbing alcohol or ammonia. This one trick can make badly streaking

& squeaking wipers change to near perfect silence & clarity.

- Ice-proof your windows with vinegar Frost on its way? Just fill a spray bottle with three

parts vinegar to one part water and spritz it on all your windows at night. In the

morning, they’ll be clear of icy mess. Vinegar contains acetic acid, which raises the

melting point of water—preventing water from freezing!

- De-ice your lock in seconds with hand sanitizer Just put some hand sanitizer gel on

the key & the lock and the problem is solved!

CORRECTION: Leg Reg Review for December 29, 2010 contained an inaccuracy regarding the Top 25 Fastest Growing Independent Insurance Agencies in the United States. The substance of the article was correct. Keystone Insurors Group won that distinction of being second from 2008-2009 but the citation was wrong. The correct citation should have been Insurance Journal National Region edition for December 6, 2010.

Tags: 11th Issue, Excess and Surplus Lines, Flood Insurance, Governor, Healthcare Reform, LEG REG REVIEW 2010, Phillips Associates, REGULATORY UPDATE, Risk Pool, Vince Phillips

LEG REG REVIEW 2011, 1st Issue January 3, 2011

Jan 4

Posted by GPAHUAdmin in Legislative | No Comments

HOUSE PICKS COMMITTEE CHAIRS

Both Republicans and Democrats designated who will chair the 2011-2012 PA House committees. Major organizational developments are the elimination of the House Intergovernmental Affairs Committee which had been chaired by W. Curtis Thomas (D-Phila.) and Chris Ross (R-Chester) and the split of the House Health & Human Services Committee into two, the Health Committee and the Human Services Committee. In all, there are ten new GOP chairs and eleven new Democratic chairs. The other shift is ideological where some committees now have chairs more conservative than their predecessors. New Labor Relations Committee Chair is Ron Miller (R-York); succeeds more moderate Gene Digirolamo (R-Bucks) who was re-assigned to chair the Human Services Committee. Labor Relations Committee originates Workers’ Compensation legislation. New State Government Chair is Daryl Metcalfe (R-Butler) replacing Kerry Benninghoff (R-Centre) who is the new Finance Committee Chair. The Finance Committee is pivotal since that’s where tax legislation originates.

Continuity prevailed in two other committees although roles of the committee chairs were reversed with the Republican being the Majority Chairman. Insurance Committee Chair is Nicholas Micozzie (R-Delaware) with Tony DeLuca (D-Allegheny) becoming Minority Chair. The Commerce Committee which handles banking and financial services is now chaired by Dick Hess (Bedford) with Peter Daley (Wash.) becoming Minority Chair.

Committee Republican (Majority) Chair Democrat (Minority) Chair

Aging & Older Adult Services Tim Hennesey (Chester) Larry Curry (Montgomery)

Agriculture & Rural Affairs John Maher (Butler) Joe Petrarca (Westmoreland)

Appropriations Bill Adolph (Delaware) Joe Markosek (Westmoreland)

Children & Youth Dennis O’Brien (Phila.) Louise Williams Bishop (Phila.)

Commerce Dick Hess (Bedford) Peter Daley (Washington)

Consumer Affairs Bob Godshall (Mont.) Joseph Preston (Allegheny)

Education Paul Clymer (Bucks) James Roebuck (Phila.)

Envir. Resources & Energy Scott Hutchinson (Venango) Bud George (Clearfield)

Game & Fisheries John Evans (Erie) Edward Staback (Lackawanna)

Health Matt Baker (Tioga) John Myers (Phila.)

Human Services Gene DiGirolamo (Bucks) Mark Cohen (Phila.)

Insurance Nicholas Micozzie (Del.) Tony DeLuca (Allegheny)

Judiciary Ron Marsico (Dauphin) Tom Caltagirone (Berks)

Labor Relations Ron Miller (York) William Keller (Phila.)

Liquor Control John Taylor (Phila.) Dante Santoni (Berks)

Local Government Tom Creighton (Lancaster) Robert Freeman (Northampton)

Prof. Licensure Julie Harhart (Lehigh) Harry Readshaw (Allegheny)

State Government Daryl Metcalfe (Butler) Babette Josephs (Phila.)

Tourism Jerry Stern (Blair) Thaddeus Kirkland (Delaware)

Transportation Richard Geist (Blair) M McGeehan (Phila.)

Urban Affairs Chris Ross (Chester) W. Curtis Thomas (Phila.)

Veterans & Emergency Prep. Stephen Barrar (Delaware) Chris Sainato (Lawrence)

RED FLAG RULE SOFTENS

According to Reading-based Stevens & Lee, the Federal Trade Commission’s Red Flag Rule which became effective December 31, 2010, has been softened to reduce the numbers/types of businesses covered by the new privacy rule. Originally advanced in 2007, the Red Flag Rule suffered enactment delays because of a succession of law suits from those interests claiming that they should not be considered as ‘creditors’ and thus subject to the Rule. The Red Flag Rule governs a firm’s identification of business customers so as to reduce identity theft and lists privacy breach compliance requirements. Traditional lenders such as banks, credit unions, and consumer discount companies are still governed by the December 31, 2011, Red Flag Rule. Although not updated with this latest information, the FTC’s web site www.ftc.gov has a quick tutorial regarding the Rule. The link to the Stevens & Lee material follows:

http://www.stevenslee.com/news/HC/redflagalert_phs_1210.pdf

LICENSE CYCLE FROM THE INSURANCE DEPARTMENT

The Insurance Department has asked PAHU and PHILLIPS ASSOCIATES to remind members and others in the Insurance Community that the licensing cycle has changed from two years from date of issue to two years from month of birth. This change was implemented last spring resulting in a change in licensing cycles. What this means is that the license expiration date on your printed license may not be accurate if your last renewal took place before April 2010. A link to the Department Notice follows:

Conversion to Birth Month Expiration Date for Individual Insurance Producers & Title Agents-Update

DECEMBER 31 MARKS END OF SURPLUS LINES 1609-X MORATORIUM

(This article is an excerpted reprint of the PA Surplus Lines Association December 15, 2010 Bulletin to Surplus Lines licensees.)

Per PSLA Bulletin of February 22, 2010, the Pennsylvania Insurance Department Directive 1609-X Filing Type, PSLA developed the process that became known as the 1609-X filing type. This process allowed surplus lines licensees to make filings that, for one reason or another, did not exist in PSLA’s database. In addition, the newly created 1609-X filing type enabled surplus lines licensees who never made filings in the first place to do so as required by law, without penalty. The discovery of these issues was a result of the reconciliation and examination process that has been in effect since June 2009.

In order to encourage surplus lines licensees to comply with these procedures, the Pennsylvania Insurance Department instituted a moratorium period during which surplus lines licensees have been permitted to waive the late stamping fee by selecting an “Omissions” box. During this moratorium period of March 1, 2010 through December 31, 2010 only the applicable stamping fee was due. As indicated in the February 22, 2010 Bulletin, the moratorium period ends December 31, 2010. The availability of the “Omissions” box and the option to waive the late stamping fee will be eliminated for these procedures. In addition, the 1609-X filing type will only be available for use in certain circumstances approved by the Department. The use of the 1609-X filing type is a means to maintain database integrity where a violation has taken place.

FEDS ASK FOR INPUT ON VALUE-BASED INSURANCE DESIGN re PREVENTIVE CARE

The US Department of Labor, US Department of Health and Human Services, and the IRS posted a request in the December 28 Federal Register pages 81554-81547 for information regarding Value-Based Design (VBID) plans relative to preventive care services mandated by the Patient Protection Affordable Care Act (PPACA), comments due by February 28, 2011. According to the Notice, VBID plans are described as including “provision of information and incentives for consumers that promote access to and use of higher value providers, treatments and services”. For more information please refer to:

http://webapps.dol.gov/FederalRegister/HtmlDisplay.aspx?DocId=24556&AgencyId=8

Tags: 11th Issue, Blues, COBRA, Excess and Surplus Lines, Flood Insurance, Governor, Healthcare Reform, LEG REG REVIEW 2010, Legislative Review, PAHU, Phillips Associates, REGULATORY UPDATE, Risk Pool, Vince Phillips

LEG REG REVIEW 2010, 22nd Issue August 9

Aug 9

Posted by GPAHUAdmin in Legislative | No Comments

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 ).

Tags: Act 51, Bad, Budget, COBRA, Design, Exchange, federal, Fllod, Good, HHS, PA, Risk Pool, State, What's New

LEG REG REVIEW 2010, 16th Issue June 7

Jun 8

Posted by GPAHUAdmin in Legislative | No Comments

BUDGET TIME IN HARRISBURG
Last week the Governor and leaders of the General Assembly met for the first time to formally begin the negotiations process which will result in the Budget for the fiscal year beginning July 1, 2010. The outlook for completion of the process by the constitutional requirement of June 30 is unlikely given that:

The budget has not been on time for the last seven years.
The Governor vowed again to fight for an increase in government spending for education. Education spending increases have been the theme of Governor Rendell’s tenure in office.
Although the PA House passed Gov. Rendell’s Budget proposal on a party-line vote, Senate Republicans pronounced it as dead on arrival, preferring to hold the line of spending at $27.5 billion instead of the $29 billion-plus sought by the Governor.
Worse yet, budgetary assumptions included in Rendell’s Budget are flawed given:

-   The $450 million-plus assumed for highways from tolling I-80 was knocked out by the Federal Government denial of the request
-   $850 million in welfare monies must be approved by the US Congress, something not happening yet
-   $801 million in this fiscal year budget struck down by the courts because of a ruling that MCARE and the MCARE Provider Retention Account money was illegally diverted to the General Fund.

Money has to be found for THIS fiscal year. The budget shortfall (revenues coming in lower than expected) means that at least $1.2 billion must be found between now and June 30 to close the books on this year. In April, collections were $390 million lower than expected, dismaying because April is supposed to be one of the most productive tax months. As of April 30, collections to date were $22.8 billion with only two months left to go in this budget cycle.

The state must reimburse $15 million to the Federal Government that was overpaid to the PA Department of Public Welfare. Another $6.5 million claim is pending.

Another budgetary development of interest to insurance producers, accountants, realtors and other professional groups is that Governor Rendell backed off from his proposal to impose the state sales tax on additional professional services.

DEPARTMENT SUBMITS RISK POOL PROPOSAL TO HHS
On June 1, the PA Insurance Department submitted a proposal to HHS to run the state’s Risk Pool for uninsured and medically uninsurable adults. It envisions $160 million spent on just over 5,000 individuals between now and 2014. It does not reference any role for agents pro or con in the marketing and outreach component except for lumping agents, insurers and legislators as one outreach category. It does not specify that marketing shall be compliant with Act 147, the Producer Licensing Law. The Pennsylvania Association of Health Underwriters (PAHU) is considering the filing of a complaint to the Attorney General and is reminding the General Assembly that authorizing legislation (SB 507 and HB 2514) appears to be side-stepped by the Rendell Administration.

CONKLIN IS LT. GOVERNOR NOMINEE
Rep. Scott Conklin (D-Centre) is the official running mate for Democratic Governor candidate Dan Onorato. He had led in the primary by just a few thousand votes but his opponent waived off a recount because the numbers, although close, were insurmountable.

FEDERAL DATES AND DEADLINES

The National Flood Insurance Program (NFIP) has for the forth time since October failed to be re-authorized by the US Congress. This means that no more flood insurance policies may be issued but claims for existing policies will continue to be paid. According to NFIP’s May 28 Memorandum, “New policies for which the application was completed on or before May 31 and application and premium were received within ten days of the application date, will be issued for coverage and will become effective on the requested effective date, in accordance with applicable waiting period rules.”
May 31 was the deadline for applying for the 65% Federal COBRA subsidy (applying to PA mini-COBRA as well). Congress did not authorize an extension of the subsidy past that date although doing so was on the congressional agenda. The House passed HR 4213 without the COBRA extension for fear of losing votes on the larger bill.
On June 10, some seniors will begin receiving tax-exempt checks for $250.00 from the Federal Government as part of the Patient Protection and Affordable Care Act’s effort to close the so-called ‘Donut Hole’. According to the Centers for Medicare and Medicaid Services (CMS) June 2, just seniors entering the Donut Hole will receive the checks, not all seniors. No paperwork or application forms are required but HHS cautioned seniors to beware of suspected fraud or scams and to call 1(800)633-4227 if such is suspected.

UPCOMING INSURANCE MEETINGS
Both House and Senate plan insurance meetings this coming week.

The House Insurance Committee will hold a June 8 informational hearing on self-referrals (HB 2521 and HB 2522) featuring presenters from the PA Ambulatory Surgery Association, the PA Medical Society, Thomas Jefferson University Hospital and others. The committee also meets on June 8 to consider:
-   HB 2522 (DeLuca-D-Allegheny) re improper referrals by health providers where there is a financial conflict of interest
-   HB 2521 (DeLuca) provides for more billing transparency and defines unprofessional conduct for health care providers that order but do not supervise or perform a component of anatomic pathology who fail to disclose certain information on its bills
-   HB 2106 (Taylor-D-Montgomery) creates the PA Health Information Exchange (not to be confused with the Exchanges coming in 2014 as part of the new health care law) to promote electronic data exchanges between health care providers.

The Senate Banking & Insurance Committee also meets June 8 on five bills: SB 1181 regarding immunity from liability; SB 1222 prohibiting insurers from charging fees for non-covered insurance services (amendment limiting to dental services); SB 1334 provides for service contracts as being distinct from the business of insurance; HB 838 regarding PA’s dependents to age 30 law; and HB 1251 providing for appealing an insurer’s determination when the benefit trigger is not met, for prompt payment of clean claims (amendment extending mini-COBRA to 15 months from the current nine)

Tags: Budget, Conklin, Federal Dates, Harrisburg, HHS, Insurance, leg reg, Legislative Review, Lt. Governor, PA, Phillips Associates, Risk Pool

LEG REG REVIEW 2010, 13th Issue May 17

May 17

Posted by GPAHUAdmin in Legislative | No Comments

TUESDAY IS PRIMARY ELECTION DAY

May 18 is show-time for hundreds of PA state legislative candidates and the state contests for Congress, Governor and Lt. Governor, partially overshadowed by the Senate Democratic contest between incumbent Arlen Specter and challenger Rep. Joe Sestak. An unsettled mood seems to have gripped the electorate and this does not bode well for some incumbents such as Specter as shown by polls. Despite polls, the only poll that really counts is the one you decide with your vote on Election Day. Please exercise your right to vote!

WHILE THEY’RE ON BREAK, CATCH UP ON NEWS…

The General Assembly is on break because of the Primary election but there are a number of legislative items of interest to help bring you up to speed when they return.

Risk pool legislation went through the Senate 49-1. Senate Bill 507 (Folmer-R-Lebanon) was amended to meet new federal requirements of the Patient Protection and Affordable Care Act such as having a six-month no insurance period prior to getting into the Risk Pool. This is a program for the medically uninsurable that will last until 2014. Although Pennsylvania is opting to have a risk pool, 18 states including neighbor Delaware have chosen to let the federal government operate a risk pool instead of the state doing it since, if the program exceeds premium revenues, the Federal Government would be on the hook rather than the state. SB 507 may have competition from a House bill being drafted now. Of interest to agents is the provision that referral fees could be paid to non-licensed persons in addition to licensed insurance agents who place people in the Risk Pool
PEO hearing was held by the House Labor Relations Committee on House Bill 2450 (Brennan-D-Lehigh). This legislation would recognize Professional Employer Organizations as a pooling of small businesses’ employees who would be covered by master contract for health benefits and Workers’ Compensation. Employees remain under direction and control of the small business but legally would be employed by the PEO. Pennsylvania Association of Health Underwriters (PAHU) submitted a statement criticizing PEOs as vulnerable to Workers’ Compensation fraud and as being destructive to the employer-broker relationships at the local level.
HB 2392 (Shapiro-D-Montgomery) extends mini-COBRA insurance coverage to 15 months instead of the current nine months. This would enable addition Federal ARRA 65% subsidy money to flow to those former employees. HB 2392 also requires reverting to nine months for mini-COBRA when the Federal subsidy ends. This has passed the House and sits in the Senate Banking & Insurance Committee.
The House Insurance Committee convened its hearing on the Community Health Reinvestment Agreement (CHRA) legislation (HB 2455-Eachus-D-luzerne) pointing to differences between the Blues versus the House Majority Leader and Insurance Commissioner Ario. HB 2455 would extend the CHRA and dedicate an increased part of the Blues’ reserves to fund the adultBasic program until 2014. The Blues maintained that they had already contributed significantly and asked lawmakers to appreciate the tightened economic conditions facing the Blues now.

A cell phone and texting while driving ban (HB 2070 sponsored by Rep. Joe Markosek-D-Westmoreland) passed the House, was amended in the Senate Transportation Committee and awaits full Senate consideration.
Senate Bill 237 (Corman-R-Centre) was signed into law as Act 14 of 2010. The law does a number of things including:

- Updating Pennsylvania’s Surplus lines Law

- Setting suitability standards for annuities

- Protecting insurers’ confidential actuarial analyses submitted to the Insurance Department from public scrutiny

- CHIP is extended through 2013

Also signed into law by the Governor was House Bill 526 (DeLuca-D-Allegheny) as Act 17. This ensures a refund of unearned credit insurance premium to consumers who pay off loans early. This was a priority of the PA Financial Services Association.

FEDERAL IMPLEMENTATION ACCELERATED

In addition to specific PA legislation required by the new federal law (Risk Pool, Insurance Ombudsman, etc.) the Federal Government has moved ahead with a number of implementations ahead of the statutory deadlines.

Some of these include:

- Ban on company rescissions from HHS (now accepted by companies; original deadline Sept. 23))

- FAQs on the new small business health insurance tax credits from the IRS

- Descriptive rules on the age 26 dependent provision of the new law by HHS, IRS and the US Department of Labor (May 10; original deadline Sept. 23 with Blues and other major carriers agreeing to keep graduating young adults as dependents June 1 rather than canceling them out and reinstating them in September)

- Early compliance by companies for the September requirement that there be no pre-existing conditions for children (March 29)

- Early retiree insurance program offers claim reimbursements to companies that will offer medical insurance for retirees aged 55-64 (May 4)

- Closing the Medicare Donut Hole: HHS says that the first $250 checks will go out to seniors June 15.

- Medical Loss Ratio (MLR) methodology by June 1 instead of end of year

MEDICAL LOSS RATIO DECISION ACCELERATED

One important new requirement is that insurers must meet a Medical Loss Ratio (MLR). This MLR methodology (what constitutes a claim versus non-claim insurer overhead) was originally set for December 31, 2010. Now, HHS has said that NAIC must submit its findings by June 1. The MLR for large groups is 85% and 80% in the small group market. If carriers violate the MLR they would have to issue refunds for the difference to customers. On May 14, the NAIC issued a press release stating that a preliminary letter had been sent to HHS regarding its efforts thus far. Also noted in the press release was an NAIC letter to HHS regarding HHS’ new authority to review health insurer premium increases as a major expansion of federal authority into the traditionally state-regulated area of rate review. (www.naic.org)

ARE YOU and your business clients CONFUSED ABOUT THE NEW FEDERAL HEALTH REFORM LAW? Vince Phillips has made dozens of presentations to business and insurance groups on the new law and its implementation timetable as it relates to Pennsylvania. If interested in such a program please contact Vince Phillips via Joan Troutman at 717/732-7255 jtrout2792@aol.com.

Tags: 13th Issue May 17, Cell Phone Ban, CHRA, Election Day, Extending Mini COBRA, Healthcare Reform, Insurance, LEG REG REVIEW 2010, Legislative, Legislative Review, MLR, PEO, Risk Pool

LEG REG REVIEW 2010, 12th Issue May 3

May 4

Posted by GPAHUAdmin in Legislative | No Comments

INSURANCE HEARING ON BLUES May 4

The House Insurance Committee plans a hearing May 4 on the renewal of the Community Reinvestment Agreement (CRA) that the Rendell Administration negotiated with the Blues several years ago to tap their resources to explicit support public sector programs such as the adultBasic program. CRA expires this year and House Bill 2455 (Eachus-D-Luzerne) would renew it and ensure more funding going to adultBasic. Only one of the bill’s 45 sponsors is Republican. HB 2455 would expire in 2014 when Exchanges begin per Federal law.

MINI-COBRA SENT TO SENATE

On April 27, HB 2392 (Shapiro-D-Montgomery) extending mini-COBRA benefits from nine to 15 months was sent to the Senate where it was referred to the Senate Banking & Insurance Committee. The bill is designed to enable unemployed Pennsylvanians from businesses 2-19 in size to qualify for the extension of the Federal 65% health premium subsidy. It also reverts back to the original nine months after the Federal subsidy expires.

WHISTLEBLOWER BILL ADVANCES

The House voted 187-0 for House Bill 2108 on April 26 to protect employees from reprisals if they report a violation of a local, state, or Federal law. Sponsored by Rep. Brian Ellis (R-Butler), the bill has 101 sponsors from both parties and represents an ideological span across the political spectrum. It was amended to specifically include whistleblower protection for employees of the General Assembly itself. It joins House Bill 2365 (Drucker-D-Montgomery) which also protects whistleblowers. HB 2365 passed the House April 20.

PEO LEGISLATION SURFACES

Legislation regulating the functioning of Professional Employer Organizations (PEOs) is the subject of a House Labor Relations Committee hearing May 5. PEOs are business entities that transfer small businesses’ employees in to a large group while still allowing control and direction to the original business owner. Proponents say that PEOs create an economy of scale with a large group re Workers’ Compensation and employee benefits. Detractors suggest that PEOs also invite Workers’ Compensation job classification issues and impedes a local insurance agency from adequately servicing the needs of his/her small business client since the employees will technically be employed by a large national concern in another state. The specific legislation is HB 2450 (Brennan-D-Lehigh) introduced April 29. There may also be questions regarding how jurisdictional authority may work regarding health insurance across state lines.

FEDERAL FLOOD SEES SOME PROGRESS

Last week the US House Financial Services Committee reported out HR 5114 to reauthorize the National Flood Insurance Program for five years. In addition, it would delay higher rates for homeowners who are newly included in flood zones because of the new rate maps. It must still pass the House and Senate before being enacted.

DEPARTMENT TAKES ‘GREEN’ ACTION

On April 29, the Insurance Department issued a press release announcing its approval of a homeowner’s five-percent insurance premium discount if the structure is LEED certified. LEED stands for the Leadership in Energy and Environmental Design, a building standard that incorporates ‘Green’ building materials and construction techniques (www.usgbc.org). Although the discount was specifically approved for Traveler’s, other such approvals may not be too far behind. The decision also recognizes additional costs associated with LEED compliant construction. The press release was silent on other similar ‘Green’ construction standards such as the National Green Building Program offered by the National Association of Home Builders (www.nahb.org). Discounts take effect June 20 for new policies and August 26 for renewed policies. In a related area, the Department previously approved discounts for homeowners using solar or geothermal energy but this is the first ‘Green’ construction insurance premium discount in PA.

ACTIONS BY THE GOVERNOR

Governor Rendell signed five bills into law April 29. One, House Bill 602 (Pashinski-D-Luzerne), expands duties of dental assistants with the goal of reducing health care costs.
The Governor has nominated Tom Gluck to be his next Secretary of Education. Gluck has been serving in an acting capacity and served former state Senator (now congresswoman) Allyson Schwartz (D-Montgomery) in the General Assembly.
May has been proclaimed as ‘Older Pennsylvanians Month’.

PENNSYLVANIA SAYS YES TO RISK POOL

Pennsylvania has joined 28 states that have notified the US Department of Health & Human Services that they intend to have state Risk Pools for those individuals who are medically uninsurable. (15 states have said that they will have HHS implement a risk pool for their residents.) Legislation must still be enacted by July to make a Risk Pool operational in Pennsylvania. Currently, the PA Senate is considering Senate Bill 507 (Folmer-R-Lebanon). Comparable House legislation has not yet been introduced.

UPCOMING

The Independent Regulatory Review Commission (IRRC) will meet May 13 in Harrisburg
The PA Office of Financial Education (Banking Department) hosts the Common Wealth Symposium in Grantville May 11-12. It focuses on providing educators with tools to better educate their students on financial literacy. Details: 717/783-2498

HITECH UPDATE

In February 2010 the new Business Associates compliance rules went into effect to strengthen privacy protections within HIPAA and to expand the liability of Business Associates (thanks to the ARRA legislation.) The HIPAA Survival Guide has just issued its May newsletter which focuses on the Business Associate issue. http://www.hipaasurvivalguide.com/

TAX AMNESTY BEGINS

The new PA Tax Amnesty Program which waives penalties and half of the interest has opened in PA for those wishing to settle delinquent tax accounts. The Commonwealth hopes to raise $100 million from this one-time program, especially important given the glum news last week that tax collections for the fiscal year ending June 30, 2010 will be at least $1 billion short of expectations. Details: www.PATaxPayUp.com

ARE YOU CONFUSED ABOUT THE NEW FEDERAL HEALTH REFORM LAW? Vince Phillips has made dozens of presentations to business and insurance groups on the new law and its implementation timetable as it relates to Pennsylvania. If interested in such a program please contact Vince Phillips via Joan Troutman at 717/732-7255 jtrout2792@aol.com.

Tags: 12th, Blues, COBRA, Flood, Governor, Green, leg reg, Legislative Review, May 3 2010, PA, Phillips, Risk Pool, Whistleblowe

Posts Tagged Risk Pool

LEG REG REVIEW 2011, 4th Issue January 24, 2011

LEG REG REVIEW 2011, 3d Issue January 17, 2011

LEG REG REVIEW 2011, 2d Issue January 10, 2011

LEG REG REVIEW 2011, 1st Issue January 3, 2011

LEG REG REVIEW 2010, 22nd Issue August 9

LEG REG REVIEW 2010, 16th Issue June 7

LEG REG REVIEW 2010, 13th Issue May 17

LEG REG REVIEW 2010, 12th Issue May 3

GPAHU 13th Annual Golf Outing

Recent Posts

Health Care Links

Archives

NAHU News

Kaiser Family Foundation News

Benefactors

Meta

Website design by RavenWood Creative.