Thursday, September 6, 2018

Changes to Federal Regulations Allow for Health Insurance Options for Iowans

Des Moines – New federal regulatory changes are providing state insurance regulators flexibility to allow options that fit the needs of individual states regarding multiple employer welfare arrangements (MEWAs), association health plans (AHPs), and short-term limited-duration plans (STLDs).  The Iowa Insurance Division is using this flexibility to put forth administrative rules that meet the needs of Iowans. 

“Each state is different and the ACA’s one-size-fits-all approach is not working for Iowans as roughly 26,000 Iowans fled this market in 2018 due to unaffordable premium rates and deductible costs,” Iowa Insurance Commissioner Doug Ommen said.  “I applaud the federal government agencies that are providing states flexibility to create rules for MEWAs, association health plans and short-term limited-duration plans that fit the specific needs of those in our state.  These types of plans will help fill the gap for some Iowans in the absence of a Congressional fix to the structural flaws within the text of the ACA which have caused rates to skyrocket.”  

The Iowa Insurance Division has adopted two sets of administrative rules, which will be effective September 12, 2018 and are available at the links below:

  • Click here to view the proposed administrative rules regarding self-insured MEWAs.
  • Click here to view the proposed administrative rules regarding fully insured MEWAs, fully insured AHPs, and self-insured AHPs.

The Iowa Insurance Division will also be putting forth one additional set of administrative rules to the Iowa Legislature’s Administrative Rules Review Committee (ARRC), which is available below.  Upon approval from the ARRC, this set of rules will have an effective date of September 12, 2018.

  • Click here to view the proposed administrative rules regarding short-term limited-duration plans.

“Some folks at the national level have wrongly tried to paint all of these options as “junk” plans.  That is not the case in Iowa.  Senate File 2349, which had bipartisan support in the Legislature and was signed by Governor Reynolds, has instructed the Iowa Insurance Division to use the flexibility provided by the federal government and Iowa common sense to create proper consumer protections while ensuring Iowa consumers have access to affordable, substantial coverage,” Ommen said.  “While these types of plans are not right for every Iowan, those who are uninsured or have been priced out of the ACA market may now have the possibility of finding a health insurance policy to fit their individual needs and budget.”

A vast majority of Iowans will not be affected by these new administrative rule changes as they currently receive health insurance coverage through group coverage provided by their employer or through a government program, such as Medicare, Medicaid or TRICARE.

Iowans will still have the option to purchase ACA-compliant health insurance coverage through www.healthcare.gov and may be eligible for a federal subsidy if their family income is between 133% - 400% of federal poverty level.  Of the roughly 40,000 Iowans that remain in an ACA health insurance policy, nearly all receive some form of federal subsidy to help pay the skyrocketing premium rates and sometimes even the deductibles.

The Iowa Insurance Division is also warning consumers to be wary of health insurance fraud.  

“Insurance is complicated, especially with all of the changes happening in health insurance,” Ommen said.  “Scammers often attempt to take advantage of folks when there are changes in law or how consumers can purchase insurance coverage.  It’s important for Iowans that need health insurance coverage to talk with a licensed insurance agent to make sure the coverage fits the individual needs of that consumer and their family.”

More than 65,000 licensed insurance agents with accident and health lines of authority are available to help Iowans find the right health insurance coverage to fit their specific family’s needs.  Iowans can search for a licensed agent at https://data.iowa.gov/Economy/Insurance-Producers-Licensed-in-Iowa-Accident-and-/esj9-c92n/data.

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