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"It came as a bit of a surprise that the Legislature only passed a fewmeasures," states Rick Byrne, market analyst for HealthLeaders-InterStudy andauthor of the report. "The result, however, did provide consumer-friendlyreforms to the state's individual health plan market."
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The measures approved would ban rate hikes on individual policies becauseof a person's health status, require insurers to notify policyholders ofcoverage options when certain policies terminate, notify those denied coverageof the reason in writing and shorten the waiting period for those with pre-existing conditions to six months, from twelve months, that insurers coulddeny coverage for those conditions. The waiting period change now puts BlueCross Blue Shield of Michigan, its competitors and all of Michigan's HMOs, inparity on that account.
The other key health plan issue at stake was the Blue plan's statutorystatus as the state's insurer of last resort. In addition to keeping thatstatus, Blue Cross Blue Shield of Michigan had asked for a shared risk poolfor those who had been declined for coverage by other insurers, and asked thatit run the pool, funded by an assessment on other insurers. A decision on theshared-risk pool has been delayed due to a provision directing the state'sOffice of Financial and Insurance Regulation to study the concept, much to thesatisfaction of other commercial insurers within the state.
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HealthLeaders-InterStudy, a company of Decision Resources, Inc., is theauthoritative source for managed care data and analysis. For more information,please visit www.HealthLeaders-InterStudy.com.
All company, brand, or product names contained in this document may betrademarks or registered trademarks of their respective holders.For more information, contact: Elizabeth Marshall Decision Resources, Inc. 781-296-2563 [email protected]
SOURCE HealthLeaders-InterStudy
