South Carolina insurance law and regulation
News that affects your health insurance and planning
June 2, 2019 – Status of alternative non-ACA health plans: South Carolina does not require individuals to maintain adequate health coverage. The state provides no premium or cost-sharing subsidies for individual market coverage, permits insurers to sell non-compliant transitional policies in the individual market. South Carolina limits the sale of short-term coverage more strictly than the federal government. A maximum policy of 11 months and a maximum under multiple policies of 11 months per year is allowed.
April 12, 2019 – The 2,000 patients served by the Bon Secours St. Francis Health System in Greenville medical facility at Pelham Road Medical Plaza will need to find another provider after that facility closes on May 3. Patients affected by the practice closure in Greenville will be able to receive care from other practices within Bon Secours, including Reedy Family Medicine at St. Francis’ Eastside campus in Greenville.
March 29, 2019 – Small business health plans – Yesterday a federal court in the District of Columbia ruled in favor of states in striking down U.S. Treasury regulations that permitted the expansion of small business association health plans. Even before the court ruling, association health plans were not showing promise as cost-saving measures as was hoped. What this means to small businesses is that if they want a lower cost health plan then they must design it themselves independently from an insurance company. The problem is that most firms providing benefits services are primarily in the business of selling insurance rather than lowering costs. Freedom Benefits offers an affordable consultation to help small business owners design and document an alternate small business health plan without necessarily requiring the purchase of insurance.
The history of health care planning in South Carolina (Information is outdated and links may be expired)
10/22/2015 Consumers’ Choice Health Insurance will not offer coverage through the South Carolina insurance exchange for 2016. The 66,000 members will likely need to find alternate more expensive alternative coverage during open enrollment season beginning November 1.
7/16/2015 South Carolinia shoppers will find fewer health insurance choices and higher prices for Obamacare in 2016 according to the head of the state Department of Insurance. There are roughly the same number of South Carolina residents without insurance now as in 2010 and the state struggles to show results from health insurance reform. One report said the percentage of uninsured went from 18.7% before Obamacre to 16.8% by the end of 2014. But if you factor in the population growth over those four years the number of uninsureds appears to be about the same.
12/18/2014 OnlineNavigator reminds South Carolina residents that it is just as important to plan for expenses not covered by health insurance. The U.S. Consumer Finance Protection Bureau recently announced that 42 million American have unpaid medical debt damaging their credit scores. Most medically-triggered personal bankruptcies are people who had health insurance. Freedom Benefits lists supplemental insurance and non-insurance strategies to keep you and your family financially secure under Obamacare.
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 South Carolina 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 BlueCross BlueShield of South Carolina is the state’s largest health insurance provider and as such, earns the right to set the benchmark for the development of the state’s essential benefit plans to debut in 2014 under health reform law.
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 A fact sheet on the South Carolina Pre-existing Condition Insurance Plan is available. This chart shows the 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.
2/3/2011 South Carolina is named as one of the states most likely to cut back on Medicaid spending and coverage. The Universal Health Insurance blog discusses the impact on the state’s commercial insurance consumers.
12/16/2010 South Carolina Department of Insurance 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, South Carolina said that it would: 1) Determine the feasibility of establishing a health insurance Exchange or Exchanges in this State in accordance with the provisions of the Affordable Care Act, 2) Generate a final report and policy recommendations on the feasibility of establishing as insurance Exchange in South Carolina. The report will set forth: a) The issues associated with the various Exchange options (governance, administration and benefit design); and b) The advantages and disadvantages of each for South Carolina as well as the cost of each option.
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 South Carolina is now available at Freedom Benefits.
3/23/2010 South Carolina and ten other states including Alabama, Florida, Michigan, Nebraska, North Dakota, Pennsylvania, South Dakota, Texas, Utah and Washington will make a joint legal challenge to the federal health reform bill on the basis that it improperly usurps state sovereignty over health insurance and that requiring health insurance is an illegal and improper government action.