News & Information

 

FEATURED PRODUCT

5500 Preparer's Manual for 2012 Plan Years
The premier resource in the field of Form 5500 preparation, 5500 Preparer's Manual will help you handle the required annual Form 5500 filings for both pension benefits and welfare benefit plans.

Learn More »

CCH® BENEFITS — 08/24/12

State Health Care Reform Update

from Spencer’s Benefits Reports: For the last few years, states have been leading the way toward more comprehensive health care coverage to ensure that more people have or can obtain health insurance. With the passage of federal health care reform, states will have increasing responsibilities in regard to employer-provided health insurance benefits. Spencer’s Benefits Reports continues to provide regular updates about state health care reform.

Arizona. The state has begun accepting enrollment into a new version of Arizona’s children’s health insurance program, called KidsCare II. The state expects the program to eventually cover 22,000 low-income children. For more information, visit http://www.azahcccs.gov/applicants/KidsCareII.aspx.

California. A federal appellate panel has held that California’s Mental Health Parity Act mandated that an insured receive benefits under her health insurance policy for residential care of anorexia nervosa. The insured was denied coverage for an eight-month stay in a residential treatment facility for her mental illness. Although the policy unambiguously excluded residential care, the Parity Act requires all insurance carriers to provide coverage for the diagnosis and medically necessary treatment of severe mental illnesses, including anorexia nervosa, the panel found. Accordingly, the insurer was obligated to pay for the insured’s residential stay subject to the same financial terms and conditions it imposed on coverage for physical illnesses, the panel concluded. The case was Harlick v. Blue Shield of California. For more information, visit http://www.ca9.uscourts.gov/opinions/view_subpage.php?pk_id=0000012263.

Iowa. Gov. Terry Branstad has signed a bill implementing an overhaul of the state’s mental health system. The law redesigns Iowa’s county-based mental health and disability system so services are delivered locally but administered regionally. Under the new law, counties will maintain their property tax levy that generates about $125 million annually for mental health services. Every county will levy the equivalent of $41.28 per person in property taxes for mental health services, an amount that will be reduced over five years with dollar-for-dollar property tax relief from the state. For more information, visit http://www.dhs.state.ia.us/Partners/MHDSRedesign.html.

Massachusetts. The state has passed a health cost control bill. The bill aims to save $200 billion over the next 15 years by linking health care cost increases to the growth of the state’s economy. This legislation is a follow up to the Massachusetts health overhaul signed into law in 2006, which focuses mainly on insurance coverage. Under the new law, hospitals and doctors will have to cut their rate of cost growth about in half. For example, instead of going up 6 percent to 8 percent per year, costs would only be allowed to rise 3.6 percent per year. However, there are no penalties on hospitals for failing to hit this goal, but a new state board could require hospitals that do not meet the new goals to produce a plan to do so. For more information, visit http://www.malegislature.gov/.

Minnesota. The MinnesotaCare program has expanded to make it easier to enroll up to 16,000 children as of July 1. The changes will allow children from families with incomes below 200 percent of federal poverty guidelines ($46,104/year for a household of four) to enroll in no-cost coverage with no barriers, such as a four-month waiting period. In addition, Minnesota has announced a partnership with the Virginia-based firm, Maximus, to design and maintain its health insurance exchange. Under the Patient Protection and Affordable Care Act (ACA), states have until 2013 to show that their state’s exchange will be up and running by Jan. 1, 2014, or the federal government will step in and run an exchange for the state. The Minnesota Department of Commerce signed a $41 million contract with the Maximus, which will design and develop technical capabilities, including a consumer-friendly website. For more information, visit http://www.dhs.state.mn.us.

New Jersey. Gov. Chris Christie has vetoed a bill to implement a state health insurance exchange. The state legislature had approved a bill that would have established an exchange in the state, and Christie vetoed the measure on the last day before the bill automatically became law. For more information, visit http://www.state.nj.us/governor/.

Oklahoma. Effective Nov. 1, 2012, employees terminated for gross misconduct are not eligible for Oklahoma’s 63-day continuation of coverage option. In addition, Oklahoma has eliminated the requirement that four months of continuation coverage be offered to terminated employees eligible for the COBRA premium subsidy created by the American Recovery and Reinvestment Act of 2009. The ARRA subsidy expired for newly unemployed workers as of May 31, 2010. For more information, visit http://www.ok.gov/oid/.

West Virginia. The state has amended its law relating to insurance coverage for autism spectrum disorders. Evaluation of autism spectrum disorders has been added to included coverage. Also, the following have been clarified: diagnosis, evaluation and treatment requirements, and reporting requirements. For more information, visit http://www.wvinsurance.gov/.

Visit our News Library to read more news stories.