September, 2010

Health Insurance: Transparent & Affordable

Although most in our community have been fortunate enough to weather the economic downturn, I have still received numerous calls from residents and small business owners seeking help with access to affordable health insurance. Several people told me that they lost benefits as a result of losing their job or business.

As a member of the legislature’s Insurance Committee, I helped craft a number of bills (now law) that will reduce health care cost burdens for many, increase access to affordable benefits and protect consumer rights. Here is a brief summary:

For those families relying on COBRA for health insurance coverage, we extended the length of time, for which former employees may buy health insurance from their former employer at the group rate, from 18 months to 30 months. This extension of COBRA benefits is actually an idea that an employer proposed, because he wanted to help the workers he had to lay off.

In today’s transitional economy, we see many families dependent on part-time employment, but all too often small businesses have not been able to offer their part-time staff health insurance, because of insurance company rules. We now require that insurance companies give small employers the option to include in their health plan part-time employees down to 20 hours per week. Currently plans may refuse to cover employees who work less than 30 hours per week.

Individuals and small employers who need to purchase health insurance will soon be able to use the Connecticut Clearinghouse, which we created to provide information on policies available to small groups and individuals.

Health insurance policies that cover intravenously and orally administered cancer medications must now provide coverage for oral medications, at the same co-payment rate, as they do intravenous medications. Some plans had much higher co-pays for oral medications than IV medications.

Towns will also now have the option to save money on prescription drugs for their employees since a new law permits municipalities to take advantage of the substantial discounts in the state employee plan.

When insurance companies deny coverage for a medical treatment, they must now inform the insured person that the state Healthcare Advocate may help them to challenge that denial or otherwise navigate the health care appeals process. We also now require  health plans to report annually their denial rates to the Insurance Department.

As the Insurance Committee considered a variety of options this year, I heard from many residents in favor of some bills and opposed to others. In the end, we passed bills that reflected compromises that were acceptable to everyone, and I believe these reforms will come as good news to many.

If you are interested in discussing the new insurance laws or any other matter, please do not hesitate to email me or call me at 860-240-8635.