| Temporary | Supplemental | Travel | HSA | Major
Medical | Life | Dental | Ancillary | International |
Group | Individual | Accident | Mini-medical | High
deductible | Emergency | Critical Illness | Prescription
| PPO | Guaranteed Issue | Pre-existing Condition
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Kentucky Insurance News2/1/2012 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 Anthem Health Plans of Kentucky and Humana Health Plan 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. 11/7/2011 Kentucky opened its Children's Health Insurance Program (CHIP) to the kids of low-income and part-time state employees, an option that was prohibited until the passage of the 2010 health-care law. The program is jointly financed by the state and the federal government to provide coverage to the uninsured children of families who earn too much to qualify for Medicaid but cannot afford private insurance. 3/10/2011 The Kentucky Department of Insurance issued clarification of the child-only insurance order. Despite the order and additional guidance, we expect that the state's commercial insurerance companies will continue to be unwilling to issue coverage until and unless loss due to litigation or enforcement by the State is an imminent. Because this enforcement process takes time, it is of little use to children who need coverage immediately. We suggest Kentucky Access or the Federal Pre-Existing Condition Insurance Plan as immediately available alternatives. 3/1/2011 Kentucky requested an exemption from the federal Minimum Loss Ratio rules in an attempt to make more affordable health insurance choices available to consumers. Due to failed attempts to legislate Minimum Loss Ratios and control insurance company profits in the 1990s, the health insurance companies that offer the nation's most affordable health insurance plans do not do business in Kentucky. We do not have any indication at this time of whether the state's effort will encourage any of the carriers listed on Freedom Benefits to expand coverage offerings in Kentucky. 2/7/2011 The state's pre-exisitng 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. 1/19/2011 Child-only health insurance for children with significant medical problems will be available through an open enrollment period mandated by federal state law during the month of July. All children, regardless of medical condition, continue to be eligible for insurance when applying as a dependent on a parent’s policy and healthy children are eligible for child-only insurance at any time. When applying for child-only insurance for more than one child, make a separate application for each child. See additional information in this separate blog post. 12/16/2010 Kentucky Cabinet for Health and Family Service 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, the Cabinet for Health and Family Service said that it would: 1) Create an interagency working group, 2) Conduct background research and analysis on the uninsured and insured populations in Kentucky, 3) Survey health insurance carriers to determine current plan designs and premium levels in the market place, 4) Perform economic and actuarial modeling to project trends of newly insured’s and the impact of merging the individual and small group markets, and 5) Visit other States with existing Exchanges to obtain detailed information on the benefits and limitations of each 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 Kentucky is now available at Freedom Benefits. |
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Opinions expressed are the sole responsibility of the author and do not necessarily represent the opinion of Freedom Benefits Association or any other person, company or entity mentioned. Information is from sources believed to be true, but cannot be guaranteed.