It may have taken decades for Congress to enact health care reform; but, they gave federal agencies just a few months to begin implementation. These time-lines are truly scary when you consider the tasks. Here is just one example. I’ll cover more in other posts.

HHS must create an Internet website to go live by July 1st that lets people shop and compare available health insurance options in their state. Let that sink in. Now consider the next fact.

HHS has until May 23rd to “develop a standardized format to be used for presentation of information relating to the coverage options.” [H.R. 3590 § 1103(b)]  It will be quite an achievement just getting quick agreement on the look and feel of the web site, let alone the format for content. All of this information must be immediately compiled and maintained. Here are the minimum required data elements for comparison:

  • % of premium spent on “nonclinical costs”
  • eligibility
  • availability
  • premium rates
  • cost sharing requirements

A good health insurance broker spends a lot of time tracking these constantly changing health plans. But not all health plan options will make the Internet list.

Companies that don’t sell major medical insurance won’t be on the list. Excluded from the list of coverage options posted on the new site – “coverage that provides reimbursement only for the treatment or mitigation of a single disease or condition or an unreasonably limited set of diseases or conditions (as determined by the Secretary)”  [H.R. 3590 § 1103(a)] Did I just hear a duck quack?

In Washington State a large share of the small group health insurance business comprises “association” health plans. These plans are offered to members of a variety of organizations from chambers of commerce and other professional groups to trade associations and agricultural organizations like the Washington Farm Bureau. Each plan is tailored to the group and filed for review with the State Insurance Commissioner. These plans marketed to organization members often offer “very competitive rates“, even by the State Insurance Commissioner’s standards. How will these plans be disclosed to Washington consumers seeking coverage? How will the new web site disclose loss and expense ratio data for plans when the information is not readily available? To whom will the site refer customers?

I felt a great disturbance in the Force, as if thousands of brokers cried out in terror and were suddenly silenced.” Obi-Wan Conniff


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