Thursday, February 10, 2011

New Rule Ensures Students Get Health Insurance Protections of the Affordable Care Act

A new proposed regulation announced today by the Department of Health and Human Services (HHS) would ensure students enrolled in health insurance coverage through their college or university benefit from critical consumer protections created by the Affordable Care Act. Students enrolled in college plans would have the freedom from worrying about losing their insurance, or having it capped unexpectedly if they are in an accident or become sick.

"Thanks to the Affordable Care Act, college students will have more control over their health care," said Secretary Sebelius. "This rule would ensure that these plans remain a viable, affordable option for students while guaranteeing that they are regulated consistently and offer transparent benefits to students."

Student health plans are often purchased when family coverage is not available, or is unaffordable. Approximately 1,500-2,000 institutions of higher education across the country offer some type of health coverage; however, what benefits are covered by these plans, as well as how they're regulated vary widely. The proposed regulation would ensure students enrolled in these plans benefit from important consumer protections created by the Affordable Care Act by clarifying that these plans will be defined as "individual health insurance coverage." Under the proposed rules, some of the new health insurance protections include:
* No Lifetime Limits on Coverage: Insurance companies would no longer be able to impose lifetime dollar limits on the amount they spend on health benefits in student health plans.
* No Arbitrary Rescissions of Insurance Coverage: Insurance companies can no longer drop coverage when student health plan enrollees get sick because of an unintentional mistake on an application.
* No Pre-Existing Condition Exclusions for Students Under Age 19: Insurance companies cannot deny or exclude coverage for students under age 19 because of a pre-existing condition.

Today, some student health plans, only offer limited benefits with low annual dollar limits on health care, or have limited networks of doctors, and other health care providers. For many students, these health plans are their only health insurance option.

The Affordable Care Act allows HHS to take steps to preserve market stability while ensuring student health plans remain affordable until all Americans have new coverage options through the state-based Exchanges that will be established in 2014. Under the proposed rule announced today, student health insurance plans would be allowed to have annual dollar limits on essential health benefits of no less than $100,000 for policy years beginning before September 23, 2012. Student health plans with policy years beginning after that date must fully comply with the Affordable Care Act's annual limit restrictions.

The proposed rules would also require insurance companies to clearly tell students enrolled in student health plans whether or not their plan meets the new requirements laid out under the Affordable Care Act-bringing transparency to this marketplace and enabling students to understand the value and quality of the coverage they have.

As a part of the new proposed rule, HHS also is requesting comments on how other Affordable Care Act protections might apply to student health plans, including the choice of medical provider and application of the new medical loss ratio rules.

To find the new proposed rule, visit For a fact sheet on the new proposed rule, visit . For more information about the new patient protections created under the Affordable Care Act, visit

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Georgia Seniors Get Very Low-Cost Medicare Supplement Insurance Policy

(BUSINESS WIRE)--A new low-cost Medicare Supplement insurance policy is now approved for sale to seniors in Georgia. The Georgia Office of Insurance and Safety Fire Commission has approved a very low-cost Medicare Supplement insurance plan for seniors and Georgia is among the first states in the nation to allow this supplemental insurance plan to be offered to its citizens. The availability of this low-cost supplemental plan for Georgia seniors was announced today by State Mutual Insurance Company of Rome, GA.

“We have eliminated a substantial cost element in this process”

State Mutual President and CEO, Dee Yancey III, said that Georgia residents of Medicare age now have access to one of the lowest cost Medicare supplement insurance plans available anywhere in the nation. Yancey said that State Mutual Insurance Company will allow Medicare-age consumers to apply for the supplemental Medicare insurance policy online, without having to talk with an insurance agent. “They can go online ( to fill out a confidential application and only buy the coverage they determine for themselves that best supplements their Medicare,” he said. “They can go forward secure in the knowledge that no one is going to try to sell them anything,” he said.

State Mutual was founded in 1936 and is licensed in 41 states and the District of Columbia. Yancey said that by using the Internet and allowing consumers to fill out their own applications online, the company has been able to substantially reduce its costs and the price it charges to consumers. “Consumers can also call the company for assistance in filling out applications,” he said.

A quick random comparison of Medicare supplement policies available in a number of states shows that the State Mutual policy is generally the lowest cost in most categories, and in some cases, costing less than half the price of the most expensive policies for the same coverage.

The online program allows an interested customer to review and select a policy, see a price quote, submit an application, receive confirmation of coverage and receive his or her policy in a few minutes of online time. Most policies will be issued within a working day, rather than the customary one- to two-month wait for underwriting review and processing. The customer can also download his or her policy and store it for review at any time. Consumers who wish to speak to a customer service representative, either to obtain information or to apply for a policy, can do so by calling 1-855-764-4000.

Yancey said that the low-cost of the State Mutual Insurance Company policy is achieved by empowering the customer to go online for most, if not all, of the information and application phase of obtaining Medicare supplement insurance. “We have eliminated a substantial cost element in this process,” he said. “This benefits the consumer who can obtain a superior insurance policy from an established company very quickly and inexpensively,” he said.

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Friday, February 04, 2011

Two Year Anniversary of Children's Health Insurance Law Sees Millions of Newly Insured Children, Families

Two years after President Obama signed the Children's Health Insurance Program Reauthorization Act (CHIPRA), HHS Secretary Kathleen Sebelius today announced that more than two million more children were served by Medicaid or the Children's Health Insurance Program (CHIP) at some point over the past year.

Together, the two programs serve more than 42 million children who would otherwise not have access to regular medical care. CHIPRA was signed into law on February 4, 2009.

"The increase in the number of children served by these two vital programs is especially significant in the face of the recent economic downturn states are experiencing," said Secretary Sebelius. "Even in times of hardship states have demonstrated their commitment to the health of children by continuing efforts to identify and enroll them in coverage."

To continue to advance coverage for children, Secretary Sebelius today also announced $40 million in new grants to states, community-based organizations, school systems and others to support their outreach and enrollment activities. The grants will help states further modernize and streamline their administrative systems, as well as create and implement school-based outreach strategies and approaches for identifying children who have historically been hard to reach.

Today's grant announcement builds on $206 million in enrollment bonuses earned by 15 states last year that increased enrollment above specific target levels. The bonus funds help states cover the cost of enrolling additional children in Medicaid.

"As we mark the second anniversary of one of President Obama's first actions as President, we can be confident that CHIPRA has proven to be a tremendous success," said Sebelius. "Now we must build on our accomplishments. Today, I am again calling on leaders across the country - from federal, state and local officials to private sector leaders - to join our effort to insure more children. We all have a stake in America's children and together, we will ensure millions more children get the care they need."

States were able to increase enrollment in the two programs in part because of boosts in federal support provided by the American Recovery and Reinvestment Act (ARRA). ARRA temporarily increased federal matching funds for state Medicaid programs during the recession.

While Medicaid and CHIP have helped bring the rate of uninsured children to the lowest level in more than two decades, an estimated five million uninsured children are thought to be eligible for one of these programs, yet not covered.

The Secretary's Challenge: Connecting Kids to Coverage, launched last year, will continue support efforts to reach more children by providing leaders with critical information and support as they work to insure more children in their communities and by closely monitoring progress.

"States' continued progress toward enrolling all eligible children in coverage is a significant step in cushioning the recession's impact on access to health insurance," said Cindy Mann, director of the Center for Medicaid CHIP, and Survey & Certification within the Centers for Medicare & Medicaid Services (CMS). "As families lose employment or have their hours cut back they may lose the health coverage benefit that came with that job. If not for these two programs, millions more children would go without critical health care services."

In its second annual report on CHIP and Medicaid enrollment, CMS notes that:

. More than 2 million children gained Medicaid or CHIP coverage during federal fiscal year 2010 (October 1, 2009 - September 30, 2010). In total, Medicaid and CHIP served more than 42 million children last year. This steady increase in enrollment is evidence of the important role that Medicaid and CHIP play for children, especially during economic downturns. The uninsured rate for children continues to decline at a time with the rate for adults is climbing. The increase in children's enrollment demonstrates that Medicaid and CHIP are serving the purpose for which they were created - providing high quality health coverage for lower-income families.

. Thirteen states implemented eligibility expansions in 2010 and many others simplified their enrollment and renewal procedures. Forty-six states and the District of Columbia now cover children with incomes up to 200 percent of the federal poverty level (FPL) in Medicaid and CHIP; with 24 of those states and the District of Columbia covering children with incomes up to 250 percent of the FPL. Twenty-one states now offer coverage to lawfully residing immigrant children and/or pregnant women, enabling states to receive federal funding for this coverage.

. CHIPRA Performance Bonuses have encouraged states to adopt and augment simplification measures in Medicaid and CHIP. Fifteen states qualified for a total of $206 million in performance bonuses for FY 2010; this is a significant increase over 2009 where 10 states received bonuses totaling $75 million. These bonuses provide additional federal financial support each year to states that successfully boost enrollment above target levels among previously eligible but uninsured children in Medicaid. To qualify, a state not only has to enroll more children, but must also have implemented program features that are designed to promote enrollment of eligible children.

. States are increasing their use of technology to facilitate children's enrollment and retention. Nearly two-thirds of states (32) have an on-line application that can be submitted electronically; 29 states allow electronic signatures on those applications. Six states have received approval to enroll children through the "Express Lane Eligibility" option created by CHIPRA. Express lane eligibility allows states to use data gathered for other programs such as housing assistance or food stamps to determine Medicaid or CHIP eligibility. And 33 states are utilizing the CHIPRA data matching process provided by the Social Security Administration to confirm U.S. citizenship for children.

. Outreach and enrollment grants have advanced coverage and led to public-private partnerships throughout the country to enroll more children. Sixty-eight grantees across 41 States and the District of Columbia are working diligently to facilitate children's enrollment in health coverage.

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