On February 13, the Department of Health and Human Services (HHS) gave conditional approval of Illinois’ request to operate a state-federal partnership exchange in 2014. HHS Secretary Kathleen Sebelius and Governor Pat Quinn announced the approval at an appearance in Chicago.
According to a press release issued by HHS and the governor’s office, Governor Quinn said, “Here in the home state of President Barack Obama, we are forging ahead to make the promise of the Affordable Care Act a reality. Access to decent health care is a fundamental right. Hundreds of thousands of people in Illinois will gain quality health coverage through the health insurance marketplace.”
The approval requires agreements regarding plan management functions and consumer outreach activities. The plan management agreement must be signed by March 1, and the consumer outreach agreement must be reached by April 1. As always, we will keep you posted.
HMO with Deductible Plans Soon Available in Illinois
On January 24, 2013, Governor Quinn signed Senate Bill 3233, amending state law to allow HMO plan designs to include deductibles. We initiated this legislation, supported by various insurance carriers and employer groups. Insurance carriers must submit form changes to the Illinois Department of Insurance for review.
Under the federal Affordable Care Act, states will define the Essential Health Benefit (EHB) plans for their exchange. Without this legislation in Illinois, HMO plans would have only been affordable in the platinum (highest cost/richest benefit) metal category in the exchange. Nearby Iowa, Indiana, Michigan, and Wisconsin have offered HMOs with deductibles for years.
For our CEO Jeff Ingrum, it was important that HMO plans remain a viable, affordable option for Illinois individuals and employer groups.
“HMO plans give members a medical home through physician-directed care and referrals to specialists,” said Ingrum. “Managed care has a proven track record of fostering quality health outcomes, which impacts the bottom line for all taxpayers.”
We plan to debut new HMO plan designs later in 2013. In the meantime, contact your client consultant with any questions.