New report: Washington State Health Insurance Pool

The state's high-risk health insurance pool, known as the Washington State Health Insurance Pool, has issued its annual report. From it:

  • The program saw a 5 percent decline in enrollment last year, probably due to the availability of a temporary (and now closing) federal high risk pool here in Washington state.

  • And claim costs increased 11 percent, from $93 million to $103 million.

Some 3,675 people are enrolled in WSHIP. These are folks that cannot find coverage at the current time in the individual insurance market or Medicare supplement market, due to pre-existing medical conditions such as kidney failure, cancer and HIV/AIDS. (Under federal health care reform, insurers next year will no longer be able to turn away sick applicants.)

Created in 1987 by the Legislature, WSHIP is overseen by a board of directors. The program is not state-funded: Premiums charged to members cover about a third of claim costs; health insurers pay the remaining costs. Administrative costs are about 3 percent of expenses.

Little-known fact: Many life insurance policies automatically end at a certain age

Did you know that many life insurance policies have a built-in end date? It’s true -- and most people don’t learn about this until their policy ends and they find themselves without life insurance.

Life insurance policies often have language that says the plan automatically ends when you turn a certain age, such as 65 or 90. If you’re lucky enough to live until your policy’s end date, you may find yourself in the uncomfortable position of being without life insurance at a time when your health might not be good enough for you to buy another life insurance policy.

To prevent that kind of unpleasant surprise, read your policy. If the policy has an end date, and if you’re still healthy enough to qualify to buy life insurance, you might want to find a different policy that doesn’t have an end date.

For more information -- including about the 10-day "free-look" period, what documents to save, etc., please see our "Tips for buying life insurance" web page.

Wellness Programs and the Affordable Care Act (ACA)

 The "trinity" of ACA enforcement (i.e., Departments of Labor, Treasury, and Health and Human Services) issued final regulations relative to wellness programs and rewards, on May 29, 2013. There were no surprises to what we already knew from the law itself.  But reviewing the briefing reminded me that there are two (2) profoundly different types of wellness programs:



Tools to help estimate the costs of medical procedures

Nationally, a number of consumer groups and government agencies have put together tools to try to make it easier to estimate the costs of a medical procedure before you have it. Among them:

Healthcare Blue Book, which describes itself as a "free consumer guide to help you determine fair prices in your area for healthcare services.

Fair Health Consumer Cost Lookup, an "independent, not-for-profit corporation whose mission is to bring transparency to healthcare costs and health insurance information."

If you're comfortable with Excel, the federal Centers for Medicare and Medicaid Services have also pulled together a lot of pricing data on the 100 most common inpatient services and 30 common outpatient services.

So what do you do if you're uninsured and are facing huge bills for a needed procedure? See our "can't afford health coverage" web page, which lists:






"Am I eligible for a subsidy to help pay for health insurance?"

As a result of the health care reform law, you might qualify for a health premium tax credit -- often referred to as subsidies -- that you could use to reduce your monthly health insurance premiums, reduce the amount of taxes you owe, or both.

Here’s a calculator that will show whether you’ll qualify for the tax credit. (Note: If your employer offers what is deemed affordable coverage -- meaning that the employee's coverage to cover him- or herself costs less than 9.5 percent of income -- you aren't eligible for the Exchange.)

If you are eligible for the tax credit, then you’ll need to decide whether you want to receive it. If yes, then you’ll need to buy your health insurance through the Exchange, also known as the WashingtonHealthplanfinder.

Health insurance plans will be available on the Exchange website starting this fall, and you can enroll in Exchange plans from 10/1/13 through 3/31/14. Plans will start as early as 1/1/14, depending on the date that you enroll.

If you’re eligible for the health premium tax credit, you can receive it by:

• Taking the tax credit in advance, which will reduce your monthly premiums;
• Using the tax credit later, when you file taxes, to reduce the amount you owe in taxes for that year; or
• Taking part of the tax credit in advance to reduce your monthly premiums, and using the rest later to reduce the amount you owe in taxes for that year.

At the time that you sign up for a health plan through the Exchange, you’ll need to tell the Exchange how you want to take your tax credit.

There’s nothing that you need to do right now; just be aware that if you qualify for and want to take the tax credit, you’ll need to sign up for a health plan through the Exchange between October and March.

For more, please see our "Health care reform -- what it means to you" page.

Job opening: Human resources consultant

We're recruiting to fill a Human Resource Consultant 3 (Senior HR Generalist) position with our agency's operations division, based at our Tumwater, Wash. office.
 
The successful candidate, with guidance from the agency's human resources manager, will use a high degree of professional judgment to consult with assigned divisions on a variety of complex human resources issues.
 
For more specifics, duties, salary, timeline, etc., please see the full job listing.

For other current job openings in our office, please see our "job opportunities" web page. At the current time, we have four positions we're recruiting for. The others include:

  • Deputy insurance commissioner for company supervision
  • Senior market analyst
  • Information technology specialist

"My company's wellness program is asking me health questions. Is that legal?"

We often hear from consumers who ask whether it's legal for their employer to ask health questions in conjunction with employee wellness programs.

Last week, the federal government issued a final rule addressing this issue. The answer: Yes, employers can do that, as long as they meet certain non-discrimination criteria. Among them:
  • The wellness program must be "reasonably designed to promote health or prevent disease,"
  • must not be overly burdensome,
  • and may not be "a subterfuge for discriminating based on a health factor."

Here’s a link to the rule where you'll find a lot more details, plus a link to an article that gives a good overview of the rule.
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