News & Events

Indiana Health Insurance for Children

Indiana Health Insurance for Children under the health reform act will no longer allow the insurance carrier to Pre X or decline children under 19 years of age.

This is the first step in Health Care reform that is going to have a huge impact on Individual policy holders and carriers. Once this goes into effect children cannot be declined or pre x for coverage.  Now all the claims on these children are going to be absorbed by the carriers. This is going to have a major impact on health carriers and major impact on individual premiums. There is some thought that we could see children’s premiums shoot up.  The insurance industry is about to feel the impact of the health care reform and policy holders will also feel the impact.

In 6 months, insurers will be prohibited from placing lifetime limits on what they will pay for your medical care,  and they can only apply restricted annual benefit limits.  Insurers will no longer be able to arbitrarily cancel your insurance policy when you get sick, except in cases of fraud.

Insurance companies will be prohibited from denying coverage to children with pre-existing conditions. This applies to all new plans in the individual market. 

In 6 months, all new individual market health plans must provide coverage for preventive services.  Recommended prevention and vaccination services will be covered without any deductibles or copayments. They must also have a straightforward and independent appeals process so you can appeal decisions by your health insurance plan. 

Beginning on January 1, 2011, insurance companies will be required to spend most of your premium dollars on your care, not on profits and overhead—75% in the individual market – and rebate any excessive overhead to enrollees.

Similarly, starting in plan year 2011, companies that sell insurance in the individual market that jack up rates will have to disclose requested premium increases publicly.  If that rate increase is found to be unreasonable, the insurer may be prohibited competing for your business in the new state-based exchange that will begin operating in 20

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.