Louisiana insurance law and regulation
News that affects your health insurance and planning
The history of health care planning in Louisiana (Information is outdated and links may be expired)
10/20/2015 Louisiana Health Cooperative will not offer coverage for 2016. Its 17,000 members can purchse alternat coverage through a commercial insurance company. The choices are Blue Cross and Blue Shield of Louisiana, Aetna Health Inc., Humana Health Benefit Plan of Louisiana Inc., Vantage Health Plan, and UnitedHealthcare Life Insurance Company.
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 Louisiana 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.
3/11/2013 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.
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 Blue Cross and Blue Shield of Louisiana and HMO Louisiana 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.
7/10/2011 The U.S. Center for Consumer Information and Insurance Oversight announced that Louisiana lacks proper resources or authority in the individual or small-group health insurance market to effectively review large rate increases as required by federal law. The federal government will temporarily take over the task of reviewing both individual and small business health insurance rate increases that are greater than 10%.
3/9/2011 The Louisiana Department of Insurance will request an exemption from the federal minimum loss ratio (MLR) rules for its health plans this year. Existing health plans are reported to be unprepared and unable to meet the requirements this year.
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.
2/7/2011 The state’s pre-existing condition insurance plan (PCIP) monthly premium rates (per person):
PCIP will cover a broad range of health benefits, including primary and specialty care, hospital care, and prescription drugs. All covered benefits are available for you, beginning on your coverage effective date, even if it’s to treat a pre-existing condition – there are no waiting periods. PCIP applicants who are approved to participate in PCIP can choose from three plan options, with different levels of premiums, calendar year deductibles, prescription deductibles and prescription copays. The HSA Option provides an opportunity to open a Health Savings Account, a tax-exempt account where you can deposit funds for eligible medical expenses. Each of the three PCIP plan options provides preventive care (paid at 100%, with no deductible) when you see an in-network doctor and the doctor indicates preventive diagnosis. Included are annual physicals, flu shots, routine mammograms and cancer screenings. For other care, you will pay a deductible before PCIP pays for your health care and prescriptions. After you pay the deductible, you will pay 20% of medical costs in-network. The maximum you will pay out-of-pocket for covered services in a calendar year is $5,950 in-network/$7,000 out-of-network. There is no lifetime maximum or cap on the amount the plan pays for your care. If you apply for PCIP coverage on the government Web site, you will be billed for the premium once your application is approved. You will need to send in your payment in order for your coverage to be effective. Please do not send in the premium before you are billed. Note that your premium may increase if you age into a higher rate tier, or if PCIP adjusts its premiums to any changes in the commercial market.
12/16/2010 Louisiana Department of Health and Hospitals officials 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, Louisiana Department of Health and Hospitals said that it would: 1) Assess governance options for the Exchange, 2) Research the legal structure that will be put in place based upon the type of Exchange selected by the State, 3) Analyze all rules and regulations issued by HHS relative to the Exchange and their impact on Louisiana, 4) Draft any legislation and or regulations relative to the Exchange, 5) Circulate drafts of legislation to stakeholders and interested parties for comments prior to the pre-filing date, and 6) Hold educational seminars and provide to leadership, members and staff of the Louisiana Legislature resources for understanding federal requirements for an Exchange and Louisiana policy makers’ role in the decision making and implementation process to ensure the State’s compliance.
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.
11/5/2010 United Healthcare is no longer offering short term major medical insurance in Louisiana. Use any of the other exchange-listed plans above under “Short Term Insurance” listings as an alternate coverage. “American Health Shield” products from United States Fire Insurance Company, Celtic Insurance Company, Markel Smart Insurance and “Simple Short Term Medical Insurance” from Fairmont Group all provide high quality coverage in this specialized health insurance niche. This coverage was previously offered through Golden Rule Insurance Company, a member of the UnitedHealthOne companies that offer health coverage to individuals. Short term major medical insurance is popular as a cost-effective alternative to COBRA or for recent graduates and self-employed individuals who do not need coverage for pre-existing conditions. The policies are priced much lower than regular major medical insurance due to this exemption of coverage for precious medical issues which can account for more than half of the cost of other types of health insurance.
5/14/2010 Diabetes Coverage: A new resource to help find health insurance for diabetics in Louisiana is now available at Freedom Benefits.