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CCH® BENEFITS — 11/6/08

State Health Care Reform Update

From Spencer's Benefits Reports: For the last few years, states have been leading the way toward more comprehensive health care coverage to ensure that more people have or can obtain health insurance. Because of the potential impact of this ongoing activity on employer-provided health insurance benefits, Spencer's Benefits Reports provides regular updates about state health reform.

Massachusetts. The Commonwealth Health Insurance Connector Authority has voted unanimously to proceed with new minimum standards for health coverage, but has added exemptions for individuals, unions, or employers that can prove that plans that have not been authorized by the state are comparable to the requirements. State-approved comparable plans must offer coverage for prescription drugs, preventive and primary care, hospitalization, mental health and substance use services, and emergency services. For more information, visit http://www.mahealthconnector.org/portal/site/connector/.

Hawaii. Beginning November 1, just seven months after it launched the state’s only universal child health care program, Hawaii no longer will fund it. According to the state’s governor, budget shortfalls (Hawaii faces a projected $900 million deficit by 2011) and other available health care options were the main reasons for eliminating the program. Also, a state official stated that families were dropping private coverage so that their children would be eligible for the subsidized plan, which was “not the intent of the program.” The state already has stopped paying for health care coverage for the 2,000 children enrolled, but private partner Hawaii Medical Service Association has agreed to pay for their coverage through the end of the year, without government support. For more information, visit http://hawaii.gov/health/ or http://www.hmsa.com/.

Florida. Beginning in 2009, the state has selected six health insurance companies to provide coverage under the new Cover Florida program. The program is open to all state residents ages 19 to 64 who have been uninsured for six months or longer. Premiums will start at $150 per month, and carriers will offer one plan with catastrophic and inpatient coverage and one without such benefits. All plans will offer coverage for outpatient and inpatient surgery, urgent care, prescription drugs, diabetic supplies, and coverage for preventive services, including some screenings. For more information, visit http://www.floridahealthfinder.gov.

Arizona. In the November election, Arizona residents will be voting for a measure that would amend the state’s constitution to prohibit laws that mandate people to obtain health coverage, or that restricts an individual’s choice of private health care systems or private health plans. Called Proposition 101, the measure also would prohibit laws that interfere with an individual’s right to “pay directly for lawful medical services” or that impose a penalty or fine on an individual who chooses not to obtain coverage. For more information, visit http://www.azdhs.gov/.

Montana. An estimated 30,000 uninsured children would be added to government-funded programs under a ballot measure that would expand eligibility for SCHIP and Medicaid coverage. The initiative also would provide premium assistance to families who have access to one or more employer-sponsored comprehensive group health insurance plans. The premium assistance would not exceed the cost of coverage for that child under the plan. Finally, the Montana initiative would provide assistance to employers that establish an IRC Sec. 125 premium-only health care benefits plan in order to allow those with dependent coverage to pay for coverage pretax. For more information, visit http://healthymontanakids.org.

San Francisco. Beginning Feb. 1, 2009, employers with 20 or more employees will be required to provide transportation benefits to employees who performed an average of at least ten hours of work per week. Employers have the option of providing a Sec. 132(f) pretax election program, a transit pass, or employer-provided transit. The new law was enacted to help San Francisco realize its goal of reducing carbon dioxide emissions by 20% by the year 2012. Employers that fail to comply with the law may be subject to civil penalties of up to $100 for the first violation, up to $200 for a second violation within the same year, and up to $500 for each additional violation within the same year. For more information, visit http://sfgov.org.

Vermont. Vermont is in the process of creating a patient registry to track patient medical conditions and treatments, guide chronic care treatment decisions, and measure health outcomes at the group and individual levels. The program is sponsored through the Vermont Blueprint for Health, a public-private initiative to improve chronic care. This system will allow Vermont citizens to experience enhanced treatment guidance at the time of each visit, electronic prescribing, and flexible reporting capability. For more information, visit http://smilevermont.com/blueprint.aspx.

Alabama. State employees now will have access to a wellness program that directly links health behavior to premium levels, according to Alabama’s State Employee Insurance Board (ASEIB). The wellness premium discount program will encourage state employees to undergo screenings for four health factors (blood pressure, cholesterol, glucose, and body mass index) that are linked to serious health conditions. Individuals who exceed the baseline for any of the four indicators will need to certify annually that they are (1) working with a physician, (2) participating in a wellness management program, or (3) reducing risks through self management. Those whose condition remains the same will not pay a penalty as long as they show that they are trying to protect their health, by, for example, participating in a wellness program. For more information, visit http://www.alseib.org/HealthInsurance/.

For more information on this and related topics, consult the CCH Pension Plan Guide, CCH Employee Benefits Management, and Spencer's Benefits Reports.

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