Connecticut insurance law and regulation
News that affects your health insurance and planning
May 26, 2019 – Status of alternative non-ACA health plans: Connecticut does not require individuals to maintain adequate health coverage. The state provides no premium or cost-sharing subsidies for individual market coverage, does not permit insurers to sell non-compliant transitional policies in the individual market and limits the sale of short-term coverage more strictly than the federal government by limiting the initial contract duration of underwritten short-term coverage to 6 months.
March 19, 2019 – This week the state’s Labor and Public Employees Committee voted to create a public health insurance option for small businesses. There is bipartisan support for expanding Connecticut’s state employee health insurance plan to include small businesses. The bill that would allow businesses to join the Connecticut Partnership Plan.
December 1, 2018 – With just two weeks left in the enrollment season for 2019 coverage, Connecticut’s Access Health reports that enrollments are higher than last year. Throughout the country many insurers report that enrollments are lower, perhaps due to the shorter enrollment season, the lack of advertising and enrollment support and the end to the individual responsibility tax penalty. Even so, Access Health reported that 101,000 people have enrolled so far this season.
The history of health care planning in Connecticut (Information is outdated and links may be expired)
2/11/ 2014 Professional support for any health care reform issue is available free of charge through an arrangement with OnlineNavigator. All online inquiries are handled personally by Tony Novak, CPA. Online support is available through a number of popular social media channels including Facebook and Google+ as well as e-mail. Telephone support for insurance enrollment is available through Members Insurance Exchange at (800) 609-0683.
7/26/2013 Affordable Smart Term Life Insurance is now available to most Connecticut residents from age 20 through 60 directly online with no physical exam, agent appointment or telephone verification. Most policies are issued on the same day with coverage amounts of $25,000 up to $350,000. The level premium life insurance is available for terms of 10, 15, 20 and 30 years. Sample rates for $150,000 coverage for a preferred risk male age 30, non-tobacco $30.85 per month; tobacco user $49.55 per month. A preferred risk female age 30 non-tobacco user would be $26.49 per month and a tobacco user would be $40.96 per month. Rates are higher for older applicants and lower health risks as described online. Pricing is based on input you provide about your medical history but, unlike most other life insurers, does not consider family medical history. Coverage is issued by innovative National Life Group, rated “A” by A.M. Best Company for 2013.
2/22/2013 This page was updated to include a link to the insurance plan that will be used to determine specific “essential health benefits” for insurance that qualified for 2014 federal tax purposes. Also, a link to additional covered benefits required by state law. Non-qualified insurance is likely to continue to be available at a lower cost that does not include these benefits nor qualify for federal tax purposes.
12/14/2012 Connecticut is one of a minority of states that will run a health insurance exchange for individuals and small businesses that is not managed by the federal government. Consumer advocates who once viewed a state-run exchange as a positive are growing concerned that the state may not be fully committed to implementing all of the funding and features expected to be part of the federal health insurance exchanges that are expected to open in the fall of 2013.
10/2/2012 The Connecticut Health Insurance Exchange is moving ahead with efforts to set up a Web-based health insurance supermarket. The exchange will be built by Deloitte Consulting. Interested parties have until November 9 to comment on plans and procedures for development of the Navigator Grant Program Policy as posted in the Connecticut Law Journal.
8/26/2012 Connecticut will spend another $107 million on its health insurance marketing systems funded by a grant from the federal government. This will bring total spending to $116 million for a system that will sell insurance to some of the state’s 337,000 residents without insurance. Freedom Benefits previously noted that the selling cost (advertising, computer systems and overhead) for a policy through the Connecticut insurance exchange will be more than $1,000 in the first year of operation. This cost is paid by taxpayers separately from the cost of the insurance itself that is already an expensive purchase. Consumer groups oppose spending on the insurance exchange noting that none of this overhead goes toward patient care.
8/16/2012 Connecticut Insurance Department approved a 9.9% rate increase for UnitedHealthOne individual insurance policies insured by Golden Rule Insurance Company. The state does not have the legal authority to oppose rate increases under 10%. The average premium for individual coverage will rise from about $360 to about $396 per month. The only other insurance company issuing a lower priced major medical insurance is Celtic Insurance Company. Celtic Insurance rates for a healthy 40 year old male range from $150 to $321 per month.
2/1/2012 The Center for Consumer Information and Insurance Oversight, a division of the Center for Medicare and Medicaid Services (CMS)reported that as of June 30, 2011 Oxford Health Insurance, ConnectiCare an Anthem Health Plans are the state’s largest health insurance providers and as such, earn the right to set the benchmark for the development of the state’s essential benefit plans to debut in 2014 under health reform law.
3/6/2011 State lawmakers are trying for a third time to make the state employees’ health plan open to small businesses this year, despite concerns of adverse selection that is driving up taxpayer cost. The health plan is not attractive to small firms with healthy employees because it is considered to be among the most expensive health plans in the state. For this reason, the Governor vetoed the law twice in the past. This option could be a good deal to very small firms whose owner or key employee needs expensive ongoing medical care. More information on this option, if approved by the Governor, will available through any private insurance exchange Navigator.
2/14/2011 Freedom Benefits anticipates an increase in consumer demand for more affordable out-of-state and supplemental medical insurance policies by Vermont’s residents in response to a repeal or revision of some of the provisions of SustiNet, the state government’s health plan. Both the state government and its primary employers say that the current health plan strategy is unsustainable. Originally SustiNet was intended to bring universal health insurance but now its backers are stymied by higher than expected costs. Some provisions are not consistent with federal law and the Obama administration is resolved to enforce the new federal law. We will announce new insurance choices in the state as they become available.
2/12/2011 With dozens of health plans choices available online offering a wide range of pricing and benefits, how do you find the best combination of price and benefits? Celtic Insurance realizes that the choices can be overwhelming; the company offers more than 40 possible health plan designs in many parts of the United States. A new feature called “Help Me Choose” lets users easily and quickly select the benefits they value most and narrows the list down to a few of the best choices. No personal information is required other than zip code and date of birth.
12/16/2010 Officials from the Connecticut Office of Policy and Management met representatives of 44 other states and numerous employees of the federal Health and Human Services Department in Washington DC this week for a two-day working meeting to discuss the next steps in establish a government-run health insurance exchange under the American Health Benefit Exchange Model Act. Their attendance at this meeting was paid for by a $1 million federal grant awarded by HHS in September to the state for research how to set up an insurance exchange. Two states (Alaska and Minnesota) declined to participate, saying that it was a waste of taxpayer money. Four other states (not identified in press reports) that received federal grants did not send representatives to the meeting. Attendees included representatives of 16 states that are suing the federal government in an attempt to overturn the federal health reform law; specifically the requirement that forces individuals to buy health insurance on the insurance exchange or pay a hefty tax fine.
In its initial federal grant request for the insurance exchange project, Connecticut Office of Policy and Management said that it would: 1) Conduct market research and Information Technology infrastructure assessments to understand the effects and implications of different policy decisions that may direct the implementation strategy, 2) Research and analyze existing data and obtain newly-collected data to assess the health insurance market and the uninsured population, 3) Conduct economic and actuarial modeling to study various policy issues that would impact the design and implementation of the Exchange, 4) Survey the small employer and health insurance markets, 5) Assess the impact of insurance reforms on premiums, 6) Analyze the local marketplace to determine whether the individual and the small group markets should be combined or separate within the Exchange, 7) Analyze the size of the small employer market segment that should start participating in the Exchange (either 1-50 employees or 1-100 employees), 8) Determine the advantages and disadvantages of a Connecticut statewide Exchange versus a multi-state Exchange, 9) Engage in stakeholder dialogue to ensure an accurate and consistent message is being communicated (includes individuals, employers, providers, legislators, insures, etc.), 10) Assess the existing Medicaid system and the interface with the Exchange information technology infrastructure required as well as specifications for the accounting and financial system of the Exchange, 11) Develop a financial model to determine administrative fees necessary for financial self –sustainability of the Exchange; and 12) Develop legislation to create the governance structure of the Connecticut Exchange.
The meeting reportedly did not address the role of the commercial health insurance exchanges on the implementation of new competing government systems. The model act does not address inter-state insurance exchange proposals nor insurance sales across state lines. Federal officials admitted that they may not be able to provide further guidance until 2012. Meanwhile, most states are motivated to continue to meet requirements to obtain additional funding promised by the federal government for the establishment of insurance exchange by 2014. Freedom Benefits has previously voiced the opinion that the huge amount of money being spent to set up alternate insurance sales system technologies could be better used providing health benefits to the public. We proposed on the Universal Health Insurance blog that adequate commercial insurance sales systems are already in place that could be modified in a public/private partnership to make health insurance more affordable.
5/14/2010 Diabetes Coverage: A new resource to help find health insurance for diabetics in Connecticut is now available at Freedom Benefits.
3/23/2010 A bill has been proposed to expand the current requirement that a health plan provide the evidence and information that were considered in the denial of a claim.