Author Archives: Karla Rockwell

The followoing was recently posted by Blue Cross/Blue Shield and explains some of the rules changes and their effects on current BC/BS customers:

“As we shared with you last week, the Departments of Health and Human Services, Labor, and Treasury released interim final rules concerning grandfathered health plans under the Patient Protection and Affordable Care Act of 2010 (PPACA).

Given the new details provided in the rules, we have determined that a decrease in benefits (e.g., increasing deductible) will result in the loss of grandfathered status and that this change may result in a future premium increase that offsets any savings from the downgrade. As a result, Blue Cross and Blue Shield of Illinois (BCBSIL) is temporarily suspending the processing of all downgrade benefit changes for individual member policies that are not currently marketed plans (i.e., closed plans). Any applications from members in closed plans for downgrades in benefits that were not processed prior to June 14 will be returned to members, explaining in additional detail this temporary change in processing policy downgrades.

Members in plans that are currently marketed (i.e., open plans) can continue to downgrade their benefits; however, those whose original effective dates were prior to March 23, 2010, will lose their grandfathered status and will be moved to a PPACA compliant version of their product Jan. 1, 2011, with an appropriate rate.”

Please note this is a temporary change for 90 days while we are reviewing the regulations and determining what changes may be allowed in the future.

Thanks,

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Welcome to my blog.  I started my blog to help those interested in understanding more about the cost of healthcare. I will be exploring issues that will impact not only the small business owner, but anyone who wants to learn more about the complexities of our current health care system. I will be writing from the patient’s point of view in order to help people make the best choices — for themselves, their families and their businesses.

Dick Durbin was recently on NPR talking about the on-going changes to health coverage.  He states that there are currently 52 million uninsured. He believes that people in the 54 to 64 age range will have a really tough time finding individual health insurance until the pre-existing condition clauses are permanently removed for all.

He also states that insurance will become more expensive until the mandates to purchase it take effect. He believes the exchanges (ability to purchase insurance across state lines) will help solve this problem.

I for one am not in favor of the exchanges because there are 50 separate sets of regulation – one for each state –which govern how much one can be surcharged for specific conditions for health and occupation.  In small groups there can be no rejection.  However, each state has different maximum surcharges.  Illinois has one of the lowest in the Midwest – 67%.  I was recently contacted by an Illinois businessman doing work in Georgia. He talked to a Georgia agent who quoted him a $1,200.00 premium for his group of two young families.  The final offer came back $3,000.00!!  The Georgia agent was using Georgia rules. In Illinois the maximum he would pay would have been $2004.00.”

If you have questions about what I have written, or would like me to address other issues in my blog, please feel free to contact me.”

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