Input sought on minimum health care rules
CARSON CITY - Southern Nevada residents can attend two Division of Insurance hearings Wednesday and tell state regulators what level of minimum benefits they want to receive in their health insurance policies.
The meetings are necessary because under the federal Affordable Care Act, most private and self-insured insurance policies, not just policies acquired by the uninsured through the law, must include a floor of benefits.
"We want to hear what Nevadans think," said Jake Sunderland, a spokesman for the state insurance division. "It is a chance to decide for the state what is important for us to provide our citizens in medical benefits."
Adam Plain, a state insurance regulation liaison, said Friday almost all private policies today in Nevada meet federal minimum standards.
But if residents want to set higher minimum benefits, then what they or their employers pay for insurance may increase.
The hearings are at 2 p.m. Wednesday in the Henderson City Council chambers, 240 S. Water St., and at 6 p.m. Wednesday in Building K, Room 101 on the Charleston campus of the College of Southern Nevada, 6375 W. Charleston Blvd.
The requirement that a floor for benefits must be included in health care policies applies to coverage sold to individuals or offered by small employers with 50 or fewer workers.
Glenn Shippey, an actuary with the insurance division said his agency must submit its recommendations for minimum coverage in Nevada to the federal government by Oct. 1.
If approved, then the minimum standards become the "essential health benefits" for individuals and employees of small companies.
The minimum floor of coverage would begin in 2014.
Plain said Congress mandated the changes because they "wanted to ensure Americans receive a certain minimum level of coverage," and not policies that provide insufficient care.
About 130,000 residents, or 20 percent of all Nevadans with nonfederally paid health insurance, eventually will have policies with the minimum benefit levels.
But Shippey said all policies, including those provided through large companies, no longer can prescribe annual or lifetime limits in the benefits they offer.
There are 10 categories of benefits - such as prescription drugs, wellness services, mental health care, hospital and maternity care - where residents can discuss with the insurance regulators whether minimum benefits should be increased or lowered.
But residents will be looking through 10 current insurance plans and choosing the one they think best meets their needs.
Plain said that the federal requirements for minimum health care benefits do not include certain autistic care services - a current requirement under state law with an annual cap of $36,000.
Private policies in Nevada include this coverage. If this benefit is provided to uninsured people acquiring insurance in 2014 through the Affordable Care Act, then the cost of premiums must be paid by the state through its general fund.
He added that estimates show the state could be on the hook for $1 million to $5 million a year, although it could be much higher.
Contact Capital Bureau Chief Ed Vogel at evogel@reviewjournal.com or 775-687-3900.
