You're Invited - Regional Listening and Planning Sessions on Dental Access

Please join us for a discussion about dental access in Ohio and to look in depth at our workforce options. Your voice is critical in creating greater access to dental care.

Release: Advocates, Medical Providers Urge Insurers to Carry-Over Medical Costs from InHealth Enrollees Being Forced to Switch Health Plans

In an open letter, the following organizations urged Ohio insurers, who enroll InHealth members, to apply the medical expenses incurred under the InHealth plan toward the new deductible and out of pocket maximum;

Press Release: Ohio Dept. of Insurance Approved Aetna-Humana Merger with Little Public Notice

On May 10, 2016, the Ohio Department of Insurance (ODI) signed off on the merger of Aetna and Humana insurance companies without a hearing. Despite the magnitude of this decision, ODI only issued a 1 ½ page decision paper, that they buried deep on their website.

 “The Ohio Department of Insurance was secretive about the merger; Ohio residents deserve transparency on a decision that will affect so many of their lives,” said Steve Wagner, Executive Director of UHCAN Ohio, one of seven consumer organizations that on February 10, 2016 submitted a letter requesting a hearing on this merger.

 “The consumers’ letter raised at least six substantive issues and the brief decision addressed none of them,” added Wagner.  “First and most important is that the merger will give the combined Aetna-Humana entity a 50 percent market share in Medicare Advantage throughout Ohio. This concentration would be made worse with Anthem (party to a separate merger request) also controlling 23 percent of the market.[1] Market concentration falls squarely within the statute that establishes the criteria for review (3901.321 (F)(1)(a) – (f), and also requires that the findings be made after holding a hearing.”  However, ODI failed to consider market concentration. In fact, ODI said “There are no facts before the Superintendent to support a determination” [that the effect of the merger would substantially lessen competition in insurance in this state or tend to create a monopoly (3901.321 (F)(1)(b)]. Since ODI has information on market concentration and can query insurers, it begs the question of how much effort was put into the investigation necessary to protect people’s health care. 

InHealth Mutual Liquidation: You Need to Act by June 30, 2016

On Thursday, May 26, 2016 the Franklin County District Court ordered the Ohio Insurance Commissioner to take over the operations of health insurance company InHealth Mutual.


This order was made because the Insurance Commissioner determined that InHealth would not be able to pay all of its claims this year if it continued to operate.


There are 22,000 people who are affected, and about one-quarter of them are in the Columbus/Central Ohio area. 

 

Here is what we know:

 

  • The Ohio Insurance Commissioner has said that if you are insured by InHealth you should pay your June 2016 premium. The federal government will pay the subsidy (Advance Premium Tax Credit) for June, just as they have each previous month.
  • If you have a plan through the Affordable Care Act (ACA) Marketplace (healthcare.gov) and want to make sure that your subsidy continues, you will need to sign up for a different Marketplace plan. You will need to do this by June 30, 2016
  • You can shop for a new plan at www.healthcare.gov.  You qualify for a “Special Enrollment Period”, which allows you to change plans.  You should call the Health Insurance Marketplace helpline at 1-800-318-2596 to arrange for the “Special Enrollment Period.”
  •  During June you can continue to use medical services, except that there is now a $500,000 limit on coverage. 
  • If you are in the ACA Marketplace InHealth Plan, you should receive a letter from the federal government explaining the details about changing plans.
  • When you change plans you will most likely have to start your deductible over.

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