News & Events

Indiana Individual Health Plan Black Out On Sept. 23rd 2010

With Sept. 23rd right around the corner health plans are ordered by law to cover certain aspect of reform.

There is real uncertainty in the carrier market. We have already seen an exodus of stand alone children policies being offered. The only carrier offer standalone children’s plan is Anthem. There is a chance that they too could pull out of that market. The problem the carriers are having is as Sept 23rd any child under 19 year age is guaranteed issue which means they can not be declined or pre x for any kind of health coverage.  This could lead to major premium increases if the policies are even available.  The government has agreed to allow the carriers to have an open enrollment period for these type of plans which will help.

The other uncertainty right now is the preventive care coverage that is being mandated under the health care reform. The individual carriers are looking to the government to give clarification on these rules. The problem then occurs is designing a plan that is compliant with health care reform and then getting the new plan design approved with the department of insurance in each state.

With these current issues we could see a black out of indiviudal coverage for new policies.  So on Sept. 23rd you might not be able to get a new individual policy. If you are in the market for a policy you need to act fast because who knows how long it could take before carriers clear up these issues with both the Federal Gov. and local Gov.  On a positive note they could get all this resolved before Sept. 23rd.

Current estimates on possible price increase for individualplans for this aspect of health care reform is anywhere from 4%-8%.  There are no available estimates on the price increases for a stand alone child’s policy.

Indiana State Children’s Health Insurance Plan (SCHIP)

This is an interesting program that very few people are aware of. If your house hold income is below 250% of the federal poverty level then you may be eligible to put your children on this health plan.

Currently in Indiana the SCHIP program is being admin through Hoosier Health wise. So for a family of 4 to be eligible the house hold income cannot exceed the 250% of the federal poverty level ($53,000).

So if you are a business owner, controller, or a citizen of Indiana you should know about this program.

Being a business owner or controller it’s important to be able to advise newly hired employees and existing employee that they might be eligible to put their kids on this program.  Currently most group health plans could cost an employee or company much more than what it would cost on SCHIP. On SCHIP two children could cost up to $70 a month in premium. In the private sector those same kids could cost anywhere from $120 and up depending on the group and plan design.

This program could help out a lot of Hoosier families.

Now here are is one of the big obstacles of the plan. The child must be uninsured for 3 months before they are eligible.  This is a huge obstacle.

From an employer standpoint they should inform any new hires with children about this option.  With the current economic conditions we are seeing a lot of families that are going uninsured do to cost. So they might qualify for SCHIP which will reduce what they are spending on premiums.

This October 2009 we might see an increase from 250% to 300% of the federal poverty level to qualify.

This program has very little advertising to it.