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Maybe They Should Have Read It



On a very personal level, members of Congress and their staffs are growing increasingly anxious about the financial impact of Obamacare.

Under a wrinkle that dates back to enactment of the law, members of Congress and thousands of their aides are required to get their coverage through the insurance exchanges.  But the law does not provide any obvious way for the federal government to continue paying its share of the premiums for the comprehensive coverage.  If the government cannot do so, it would mean that they would be responsible for paying an additional  $5,000 a year for individuals and $11,000 for families under some of the most popular plans.

“It’s a very serious concern,” said Representative Billy Long, a Missouri Republican who said staff members were “freaked out” at the prospect of paying the full cost of insurance out of their own pockets.  " We have tried, and tried, and tried to get the answer on what they’re going to be paying. The Office of Personnel Management cannot tell us.”

With enrollment in the exchanges scheduled to begin October 1st, the Obama administration is struggling to come up with a creative interpretation of the health care law that would allow the federal government to kick in for insurance as private employers do, but so far they have been unable to find a solution.  The issue is  a political mine field because the White House and Congress are highly sensitive to any suggestion that lawmakers or their aides are getting special treatment under the health law.

During the debate over the health care law, Senator Charles E. Grassley of Iowa proposed the idea that members of Congress and Congressional staff get their employer-based health insurance through the same exchanges as other citizens and the suggestion was included in the final bill.  It has been a headache for many in Congress ever since. Democrats and some Republicans wish the issue would simply disappear.

Since the law generally requires lawmakers and aides who work in their personal offices to get coverage through the exchanges it implies that they would no longer receive coverage through the Federal Employees Health Benefits Program.  The Federal Employees Health Benefits Program, the nation’s largest employer-sponsored health insurance program, covers more than eight million people, including government employees and their family members. It offers dozens of competing plans and has been cited as a model by members of both parties.

What the law does not do is clearly authorize the government to pay premiums for federal employees who obtain insurance through the exchanges and it doesn't authorize the government to reimburse federal employees who buy health insurance on their own.  David M. Ermer, a lawyer who has represented insurers in the federal employee program for 30 years, said, “I do not think members of Congress and their staff can get funds for coverage in the exchanges under existing law.”  “Perhaps,” he said, “they could buy coverage on an exchange, pay for it on their own and be reimbursed later by the government. You would need a law to appropriate money for that.”

 

Contact Heather Matias Ainesworth for group quotes and other information relating to health care reform.

 

 

 

Anthem Blue Cross Says No To California



Anthem Blue Cross said it will not participate in California's new insurance market for small businesses.


Anthem, a unit of WellPoint Inc., is California's largest insurer for small employers. This surprising move could hamper the state's ability to enroll businesses in its new exchange called Covered California that opens Jan. 1 as part of the federal healthcare law.

Instead, Anthem said it will keep selling coverage to small firms outside the exchange in direct competition with the state-run market. Anthem also remains one of 13 health insurers that will offer policies to individuals in Covered California.

The state had required health insurers wanting to sell in the individual exchange to also participate in the small-business market, which is limited to employers with 50 or fewer workers.

Darrel Ng, a spokesman for Anthem, said Covered California lifted the requirement last month so the company opted to leave what's known as the SHOP, or small-business health options program.

"Because Anthem is no longer required to participate in SHOP as a condition of being on the individual exchange," Ng said, "Anthem has withdrawn its SHOP application. Anthem will continue to participate in the individual exchange.”  Anthem also said it will remain part of a private exchange for small firms called California Choice.

Anthem led California with 31% of the small-employer market in 2011, according to the most recent Citigroup data. Kaiser Permanente was a close second with a 28% share, followed by Blue Shield of California with 18% of small firms.

Several other major insurers have already spurned California ahead of the health law rollout. In May, UnitedHealth Group Inc., Aetna Inc. and Cigna Corp. opted not to participate in the state's individual exchange.

Last month, both UnitedHealth and Aetna went a step further and announced they were leaving the state's individual market entirely at year end, leaving nearly 60,000 customers to find new coverage.


Contact Heather Matias Ainesworth for group quotes and other information relating to health care reform.

 

 

 

Assurant Offers Third Quarter Bonus

Assurant has a bonus program for the third quarter of 2013.  Starting with the 11th enrollement,  they will pay a $100 bonus for every employee with an effective date from  8/1 to 10/15. 

Contact Heather Matias Ainesworth for details.

 
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