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The Regulatory Stew

Boring but Important

Finding, reading, and understanding the thousands of regulations that apply to health plans can drive a sane person to drink Flint, Michigan water. But not me. My sanity has already been questioned given that I intentionally spent a lot of money to go to school so I could learn the discipline of memorizing convoluted regulations…

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When Discrimination is a Good Thing

Words matter. The meaning and use of words matter even more. That’s why discrimination can be a great thing – if you’re talking about insurance. Why? For one reason, folks who are careless should pay more for insurance than folks who are careful. Insurers don’t care why folks are careless; insurers want to be “discriminatory”…

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President Proposes Elimination of MEWA Common Bond Requirement

President Obama surprised many folks today by proposing to allow small employers and the self-employed to form multiple employer plans without regard to the “common bond” standard required by the Department of Labor. The elimination of the “common bond” requirement would eliminate one of the highest hurdles to the creation of group benefit programs for…

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Another AHP Challenge to Insurance Commissioner

And now for something completely different. Since 2004, Washington State has required all self-funded Multiple Employer Welfare Arrangements (MEWAs) to obtain a certificate of authority to conduct business in the state. The statute imposes strict standards of eligibility and detours from federal ERISA interpretations of “bona fide association” with its own unique statutory definition: “Bona…

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Insurance Commissioner Proposes TPA Regulation

The Washington Insurance Commissioner has requested legislation for registration of third party administrators to protect consumers. Third party administrators (TPAs) come in all shapes and sizes and just as many flavors. Insurers typically provide most services for administration of its own health plans. Many Insurers also sell administrative services to self-funded plans which would make…

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Insurance Commissioner Explains AHP Settlement

The ranking member of the Washington State House Health Care Committee, Representative Joe Schmick, read my recent association health plan (AHP) post and shared the Insurance Commissioner’s letter explaining the agency’s recent actions. In his letter, the Commissioner addresses the administrative law judge’s decision disapproving the agency’s rating requirements. Disagreement over bona fide status was…

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