Public Announcements

 

NAHU Nebraska Members Update

 

Hope everyone is having a great 4th Quarter.  I wanted to give you all a brief overview of our last meeting with Director Ramge and his staff with the Nebraska Department of Insurance(DOI).  Sometimes these issues are topical with your clients as you meet for renewals this time of year.  Here are a handful of items that were discussed at the meeting or in email conversations since.

Section 1332 Waiver  - This program allows states to come up with what they deem as a better way to provide residents of the state health insurance while still retaining the basics of the ACA.  We have asked on numerous occasions if NE would be willing to explore this waiver program and haven’t received a very clear response until recently.  Ultimately the answer is no and they have spelled out the several reasons as to why that is. 

We aren’t going to apply for a 1332 waiver for several reasons. First, it cost money to do the study that is relevant to what the state wants. In some cases, like Oklahoma, they spent a $1M to only subsequently withdraw their application. Iowa can say the same story. 

Let’s say we go down the route of reinsurance like most states. Two things have to happen, the state of Nebraska has to initially fund it, typically for millions of dollars. Millions of dollars the state doesn’t have or has appropriated in the budget. 

Next, the legislature must pass contingent legislation in the event CCIIO doesn’t approve the 1332 waiver. That is illegal under our state constitution. We have asked the feds numerous times if that could be waived. They say no. We have asked if we could forego putting up money up front like every state has had to in the past. The answer is no

In states that have had it approved, they have made purposeful allocation of money. Alaska has dedicated ALL of its premium tax to a reinsurance plan. And they raised premium taxes to boot.  Minnesota has to come up with general funds to pay for it as well. 

Association Health Plans – These have been around for a long time, however earlier this summer the Trump administration came out with new rules defining some news ways these associations can be formed.  Our DOI has basically said that they are fine with the new rules as they are written.

Many associations are popping up because of the increased discussion, but they have been built around the old rules that have existed for a long time. 

There are two main differences between the old rules and the new ones, and both are still an option.  First, is the ability to medically underwrite an individual or group.  Second is that sole proprietors are eligible vs only employers with common law employees.  The old rules allow for underwriting and require that groups have common law employees. The new association rules do not.  The Farm Bureau has created one in Nebraska based off of the new rules to help their members that have been stuck paying high individual prices when they don’t qualify for a subsidy.  This works because many of their members are farmers(sole proprietors) and they can’t qualify for traditional group coverage that is much less.  This may be a good option for other groups as carriers gain some rating experience managing these new associations.

Short Term Health Plans – These have been around for a long time as well, but some adjustments have been made again this year.  Late in 2016 they were restricted to three month contracts.  The new rules allow for them to be sold with 364 day contracts again and allow for possible extensions up to 36 months.  Our DOI is ok with these new rules but have required insures to list a number of new disclosures in their marketing materials.  This is to limit the confusion that the general public might have when buying these plans.  They don’t want anyone to think they are buying an ACA plan instead of a short term plan.  These plans are many times a good fit for individuals who aren’t subsidy eligible and don’t have preexisting conditions with expected expenses.

Medicaid Expansion – We met before NE voted and passed the new expansion rule, but the assumption at the time was that it would pass.  This will obviously change low income individual’s eligibility in the marketplace.  Next steps require Nebraska Medicaid to put forth a plan by April 1st.  It can be repealed by the legislature, but will require a 2/3rds vote.  Assuming that doesn’t happen, the changes will go into effect on Jan 1st 2020.

LB486 Passed! – This Nebraska bill addressed the continuing education requirements for Insurance Producers that are actively participating in their professional association.  It allows those members who are considered active to get 6 CE credits waived of the 24 that are currently required every 2 years.  As a state association NAHU is still working out some of the details, but one part we know for sure.  If you serve on the local or state boards in a committee role or as an active board member you will for sure meet this requirement.  We would love to see more people step up and provide input on these boards and in their committees, so let me or chapter administrator Joe Pittman know if you have interest in helping out.

Paul Scholz

NAHU State Legislative Chair

pscholz@ociservices.com

402-330-8700