Pertinent Federal Law Review Pertinent to Florida Licensed Insurance Professionals

 

Each state’s insurance director manages most insurance issues and products at the state level. There are, however, instances in which the state and federal governments work together, for example, Medicaid is a state

 

Pertinent Federal Law Review Pertinent to Florida Licensed Insurance Professionals

 

Each state’s insurance director manages most insurance issues and products at the state level. There are, however, instances in which the state and federal governments work together, for example, Medicaid is a state and federally funded program.



State and Federal Relationship


There is a relatively new (3-years) Federal Insurance Office (FIO) that was created by the Dodd-Frank Wall Street Reform and Consumer Protection Act (DFA), which, so far, has allowed states the same freedoms as before creation of the FIO.

The fall of the economy, during which we endured the exposure of an insurance industry debacle, played a significant role in Title V of the DFA. It created the FIO and appointed a director who had previously been the acting Insurance Director in Illinois, and an officer for the NAIC. This appointment allowed a voice for the state-run industry and, as the director said during his first press conference, the FIO has refrained from stepping into state lines. He can, however, intervene if a reasonable request is made. The FIO authorities extend to all lines of insurance except health and LTC insurances (except those lines of insurance included with life or annuity components).

 

Although the FIO states, “authority extends to all lines except health … “ we can hardly call the Affordable Care Act “health insurance without federal input!” We have been virtually hit over the head with volumes of Affordable Care Act documentation, rules, policies, and dates. The Act is set to run on a rolling calendar, which results in yearly changes to the rules you become accustomed, each time January 1st rolls around. On a Federal level, these are AFA laws for 2014 and 2015.

 

 

Affordable Care Act Updates

 

In 2018, like preceding years, changes in the ACA affect some Floridians.
Open enrollment periods were reduced by half, although individual states could choose to keep them longer than federal law now mandates. Federal enrollment dates are now from November 1 to December 15. Florida has had the highest exchange enrollment in the country, with nearly 2 million Floridians enrolling through the health insurance marketplace. Of those enrolling, 90 percent of the participants have received some amount of premium subsidies, reducing the amount they pay per month by around 75 percent.

Centers for Medicare and Medicaid Services has acted to ensure those affected by hurricanes do not miss open enrollment periods, with special extensions allowing them until December 31 to enroll.

2018 was the last federal tax year that individuals will be penalized if they chose not to purchase health care.

Six insurers offered coverage in Florida during 2018. However, people did not have access to all insurers in all areas of the state. In some counties, it is possible that only one insurer offered health care coverage. For individuals qualifying for health care subsidies, coverage must be purchased through the ACA to receive the subsidy.

 

Highlights and updates

1. Open enrollment for 2019 coverage in Florida ended on December 15, but residents in most of the panhandle have until February 16, 2019, and some insurers have extended off-exchange enrollment until December 31.
2. Enrollment is still open for Floridians with qualifying events.
3. Short-term health plans are available in Florida with initial plan terms up to 364 days.
3. Seven insurers offering plans for 2019, including newcomer Oscar; average rate increase 5.2% for 2019.
4. Florida has the highest exchange enrollment of any state in the country, and enrollment reached a record high for 2019.
5. 2018 premiums: Average approved rate increase was 44.7%
6. Most of the rate hike was on silver plans, due to CSR uncertainty. Silver plans continue to have disproportionately high premiums.
7. Subsidies are much larger than they were prior to 2018, after-subsidy premiums lower for many
8. Humana exited for 2018, but only offered plans in 7 counties in 2017
9. Celtic/Ambetter expanded in 2018, offering plans in 22 counties
10. Health First expanded from 4 counties to 5 in 2018, but is back to 4 counties in 2019.
11. Consumers protected against surprise balance billing

Source: https://www.healthinsurance.org/florida-state-health-insuranceexchange/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 Text Box:  © 2015 Wall Street Instructors Online, LLC. 
No part of this material may be reproduced without the written permission of the publisher.

 

 

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