By Trish Pearson
Insuring Your Future
Trish Pearson.
The Connecticut legislators were busy this past session proposing many bills that would impact insurance coverage. As of the end of session, though, a limited number passed and were sent to the governor for his signature.
The bill that has the largest impact is the Family Medical Leave Act. This legislation guarantees workers in Connecticut up to 12 weeks of paid leave for personal or family medical reasons at 70 percent of their monthly earnings.
At this point it is not clear how the benefit will be administered. One proposal is that it be administered by an insurance carrier, another is that the state would hire a subcontractor to run the program. While the cost of the program would be funded by a 0.5 percent payroll tax, the greater cost will be to employers who will have to hold a position open during the leave period.
Certain health insurance plans will be mandated to allow special enrollment for pregnant women. It applies to individual health plans subject to the Affordable Care Act HMOs, and hospital and medical service corporation contracts offered to individuals. This will allow women to enroll in a health insurance plan or to switch plans if their plan does not cover maternity.
There was also an expansion of breast imaging services that certain health insurance plans must cover. This provision requires that insurance companies cover more than a basic mammogram. Many women are also recommended to have an ultrasound and plans should cover all or most of the cost
Mental illnesses must now be treated the same as other illnesses by health insurers. The bill requires insurers to cover mental health and substance disorder treatment at the same level as physical health. The bill also requires insurance companies to submit documentation annually to prove they’re complying with the legislation. Copays, co-insurance and benefit limits must be comparable to benefits provided for treatment of other illnesses. Some insurance companies currently limit the number of visits in a year or number of days covered in an inpatient treatment facility. This will no longer be allowed.
The Medical Savings Program, which provides benefits for reduced costs on prescription medications, as well as the Medicare B premiums and copays were left intact. The income limits will remain the same and will not include assets – which had been on the table.
Individual insurance will again only be available through the health care exchange. The proposed “Affordable Care Legislation” did not pass. While it would have provided an option for small businesses to purchase group plans through a state sponsored plan, there were too many unknowns for it be approved before the end of the session. It appears that the insurance companies who currently participate on the exchange will stay the same. It remains to be seen if there will be any additional players. Access Health is awaiting direction on the income levels for advanced premium tax credits.
In the meantime, enjoy the summer and get ready for Medicare and individual open enrollment this fall.