Legislative

PA-NABIP would like to introduce your Legislative Committee leadership. The Legislative Committee is responsible for educating our members about relevant legislative and regulatory matters, working with lawmakers to communicate policy positions, and staying on top of the legislative process. We are your resource for questions about legislative or regulatory issues. As a state association, we work primarily with the PA Insurance Department and state lawmakers on issues germane to PA laws. However, our legislative committee is made of up individuals on the national NABIP Legislative Council and national working groups, so our focus goes beyond what is happening in PA. The committee includes members from across the Commonwealth representing the geographic diversity of our membership. The committee’s three Vice Chairs each bring a unique perspective of issues impacting their region of the state.

Vicky Cagliola, Legislative Chair

Vicky’s role at Alera Group is to oversee the national ACA Compliance practice. She is also a CPA licensed in PA and holds a master’s degree in business administration. Vicky has been a member of her local NABIP chapter for over 8 years and previously served as local legislative chair. Currently, she is a member of the board of directors and the finance committee of PA-NABIP. Vicky is serving in her third term as the PA-NABIP state legislative chair.

Joshua Brooker, Legislative Vice Chair Central

Joshua has spent the last 11 years as a health insurance broker, holding a BS in Finance from Penn State. His passion ignited after a billing error related to his son’s birth. Since then, he has dedicated himself to guiding individuals and seniors through healthcare’s financial challenges. He serves as the PA-NABIP representative at Pennie and is actively involved federally on the NABIP Legislative Council, Quality/Price Working Group, and as chair of the Individual Market Working Group. Through his roles within the organization, and externally in collaboration with CMS/CCIIO, he advises on policy with a steadfast focus on the role of community-based brokers and the consumers they serve.

Alexis Bruni, Legislative Vice Chair East

Alexis has been in the employee benefits industry for more than 15 years, nine of which she has spent as a member of the local and state chapter of NABIP.  In her role with OneDigital, she manages benefits portfolios for their large group clients.  Alexis holds a Master’s Certificate in Healthcare Compliance Law and is currently working on her Master’s in the Study of Law from the University of Pittsburgh School of Law.   She previously served as the local legislative chair.

Jacob Lauten, Legislative Vice Chair West

Jake has worked in the insurance industry for over 10 years.  He previously regulated insurance companies as a specialist with the Alaska Division of Insurance.  Now a senior analyst with Cowden Associates (Acrisure), he ensures client compliance and reviews claims data for developing strategic solutions.  He graduated from Penn State with a degree in Actuarial Science.

State legislative tracker

Follow this link https://nabip.org/advocacy/state-legislative-tracker
and click your state and get more information.

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Compliance Corner

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PA-NABIP Pulse February 2024

PA-NABIP Pulse February 2024 The Facts of the Month Here is something to mention when discussing coverage trends in the month ahead. Prescription drug costs are a top concern for the American public. While retail prescription drugs represent less than 10% of total...

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PA-NABIP Pulse January 2024

PA-NABIP Pulse January 2024 The Facts of the Month Here is something to mention when discussing coverage trends in the month ahead. New research released by the Kaiser Family Foundation provides key demographic details about people who do not have health insurance...

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PA-NABIP Pulse – December 2023

Here is something to mention when discussing cost and benefit trends with clients in the month ahead. The United States spends more, both per capita and as a percent of GDP, on health care than any other country, yet fails to achieve commensurate health outcomes. One...

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GPAHU Pulse – November 2023

Here is something to mention when discussing cost and benefit trends with clients in the month ahead. The average annual premium for employer-sponsored health insurance in 2023 is $8,435 for single coverage and $23,968 for family coverage. The average annual single...

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GPAHU Pulse – October 2023

Here is something to mention when discussing cost and benefit trends with clients in the month ahead. IRS Notice 2019-45 allows health savings account (HSA)-eligible health plans the flexibility to cover 14 medications and services used to prevent the exacerbation of...

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GPAHU Pulse – August 2023

Here is something to mention when discussing cost and benefit trends with clients in the month ahead. Mental health needs among workforces continued to climb this year, with 77% of large employers reporting an increased interest in mental health coverage and another...

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The PA-NABIP Legislative Committee welcomes your questions and suggestions. If you need help meeting with your local representatives or would like to learn more about either in-district meetings or attending NABIP’s Capitol Conference, please reach out to the committee at advocate@PA-NABIP.org.

PA-NABIP Pulse February 2024

PA-NABIP Pulse February 2024

The Facts of the Month

Here is something to mention when discussing coverage trends in the month ahead.

Prescription drug costs are a top concern for the American public. While retail prescription drugs represent less than 10% of total U.S. health spending and are not the primary driver of the nation’s high health costs, Americans often pay more for the same prescription drugs than people in other countries spend and survey data shows they are unhappy about it. More than six in ten adults (63%) say that drugs developed over the past 20 years have improved the lives of Americans, though an even larger majority (82%) say drug prices are unreasonable. That may explain why majorities of Republicans, independents and Democrats say there is too little regulation of drug prices and support a wide range of policy actions to rein them in.

Source: Kaiser Family Foundation Health Tracking PollThe Big Three

Each month GPAHU identifies three top public policy or legal developments that could impact our members and clients. Here are this month’s big three!

  1. Pennsylvania Insurance Department Makes Licensing Both Easier and Cheaper

To make the insurance licensing process more accessible and less burdensome, the Pennsylvania Insurance Department (PID) recently announced major program enhancements and fee reductions. As of January 1, 2024, anyone seeking licenses through the PID can now submit any of their forms online, and new applications and information materials are being used which include clarifying information for applicants and enhanced instructions.

Furthermore, the PID has removed the $25 processing fee previously charged to make any of the following licensing changes:

  • Add or Remove Designated Licensee or Surplus Lines Affiliation
  • Add or Remove Self Storage Service Location
  • Add or Remove Fictitious or DBA Name
  • Address Change Form for Business Entity
  • Name Change form for Business Entity
  • Name and Address Change for Individual
  • Letter of Clearance or Voluntary Surrender Request

To encourage more people to seek insurance licenses, examinations are now available in Spanish and Chinese. The PID has also reduced the time it takes to review pending applications. By increasing their licensing staff, and by receiving background checks

electronically, the PID can now process applications in eight days or less, down from the previous average of 20 days.

  1. Medical Debt and Enhanced Pennie Subsidy Proposals Feature in Governor Shapiro’s 2024-2025 Budget Proposal

On February 6, 2024, Pennsylvania Governor Josh Shapiro released his proposed budget for 2024-2025. On the health front, in addition to proposing $100 million for significantly more school and county-based mental health resources, Governor Shapiro’s budget request included plans to create a new program to provide medical debt relief to Pennsylvanians and the intent to spend $50 million to further subsidize health insurance premiums for low-income customers of Pennie, the Commonwealth’s health insurance exchange marketplace.

The new medical debt relief initiative would cost $4 million and according to the proposal, the state would partner with a to-be-determined organization that purchases medical debt in bulk, eliminating patients’ responsibility for paying it off. Pennsylvanians with family incomes below 400% of the federal poverty level and to people whose medical debt exceeds 5% of their household income would be eligible to apply for debt elimination assistance. Estimates indicate a $4 million investment by the Commonwealth could lead to forgiveness of as much as $400 million in the medical debt held by approximately 25% of Pennsylvania residents.

  1. New Federal FAQs on ACA-Related Policies

Federal policymakers recently released two new sets of FAQ-style guidance related to Affordable Care Act (ACA) policy issues. The first involves the ACA’s preventive care requirements and updated policy regarding first-dollar coverage of contraceptives. The second addresses the ACA’s premium tax credits and how eligibility may relate to the affordability of employer coverage for both eligible employees and their family members.

The new contraceptive coverage FAQs addresses the ACA preventive care requirement of providing adolescent and adult women access to the full range of contraceptive care approved by the Food and Drug Administration (FDA). Non-grandfathered health plans must cover at least one form of contraception listed in each category of the FDA’s Birth Control Guide (with the exception of sterilization surgery for men), as well as any additional contraceptives approved, cleared, or granted by the FDA determined to be medically appropriate for the individual. A plan can impose medical management or cost-sharing on some forms of contraceptives within a category, as long as they cover at least one therapeutic equivalent in the category on a fist dollar basis. However, if a plan decides to do this, and not just cover all contraceptives in a category first-dollar, then they must make an exception process available. That way, if it is medically necessary for a woman to have access to a particular birth control method or product, she will still have an opportunity to access it free of charge.

The updated premium tax credit eligibility FAQs provide more information about how exchange market tax credit eligibility for dependents who have been offered group coverage works and does not work. For example, they specify that even if a dependent has one offer of employer coverage that is “unaffordable,” but has any others that are “affordable”, then they are not eligible for a premium tax credit. In addition, the new guidance provides updated information about reporting, claiming, and reconciling premium tax credits on personal income tax returns and new information about the impact of unemployment compensation on tax credit eligibility.

Check This Out!

If you want to expand your health policy knowledge beyond this newsletter, here is a resource to check out!

The Alliance for Health Reform’s Health Policy Handbook is designed to serve as a primer for anyone who is interested in a quick-study of the key foundations of health policy. This Handbook features a collection of six chapters, each devoted to one core health policy topic and supplemented by extensive resource lists.


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