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Insurance Department Encourages Consumers to Shop Around as Open Enrollment Period Begins
Posted on Sunday October 29, 2017

BISMARCK, N.D. – As the 2018 Open Enrollment Period will begin on Nov. 1 and end Dec. 15, many North Dakotans must soon make critical decisions about their 2018 health insurance amid a barrage of news and opinions regarding healthcare. To help make the most informed decisions possible, the North Dakota Insurance Department encourages consumers to streamline their health insurance research process.

“Health insurance plans and coverage can change drastically from year to year,” Insurance Commissioner Jon Godfread said. “This is why it is so critical that as the Open Enrollment Period begins, North Dakotans thoroughly research coverage options to determine the best plan for themselves and their families.”

According to the U.S. Census and Kaiser Family Foundation, in 2016, most North Dakotans accessed health insurance in one of three ways:

  • Employer-sponsored – 55 percent participated in a group health insurance plan offered by their employer. This includes employees of large and small private companies, federal, state and local government employees and active military.
  • Public Programs – 29 percent received healthcare benefits through Medicare and Medicaid.
  • Individually-purchased – 8 percent purchased health insurance on their own through the marketplace or an agent.
  • Uninsured – 8 percent remained uninsured.

Within each method there are important developments and information consumers should keep in mind as the Open Enrollment Period begins:

Employer-sponsored Health Insurance

  • If already covered by an employer-sponsored plan, consumers should pay close attention to enrollment options this year. Premiums and coverage limits may have changed.
  • If an individual has recently changed jobs or plans to change employment, they may be subject to a probationary period, up to 90 days, during which they are ineligible for group coverage.
  • If coverage from a previous employer is lost, an individual typically has 60 days to enroll in private individual insurance through a Special Enrollment Period.
  • Consumers are encouraged to contact their employer with questions about their Health Savings Account or Flexible Spending Account, or if they have questions about enrolling in either.

Public Health Care Programs

  • Medicare and Medicaid are government programs that help pay for health care. However, benefits, costs and eligibility requirements differ:
    • Medicare is a federally funded program available to most U.S. citizens and permanent legal residents age 65 or older who have lived continuously in the country for at least five years. People younger than 65 may also be eligible for Medicare if they are disabled, suffer from kidney failure or ALS (Lou Gehrig's disease).
    • By contrast, Medicaid is jointly funded by federal and state governments. Eligibility is means-based and the program has strict income requirements that vary from state to state.
  • Open enrollment for Medicare Advantage and Medicare Prescription Drug coverage (Part D) takes place from Oct. 15 through Dec. 7, 2017. If an individual misses the deadline and didn’t experience a qualifying event, they can still apply during general enrollment (Jan. 1 through March 31 of each year), though they will have to pay a premium penalty.
  • High-income earners (above $133,500) may see increases in 2018 Medicare Part B premiums. Enrollees should contact Medicare for an estimate and plan accordingly.
  • Medicaid enrollees should pay particular attention to possible changes to eligibility and coverage options.

Individually-purchased Health Insurance

  • The 2018 Open Enrollment Period will run Nov. 1 through Dec. 15, 2017. Coverage begins Jan. 1, 2018. Consumers can begin researching their options at any time.
  • Those who currently have coverage through the Exchange and do not choose a plan for 2018 will be re-enrolled in the same or a similar plan. Consumers should take notice that this re-enrollment could result in higher out-of-pocket costs.
  • Consumers can now enroll in the Exchange through third-party insurers’ websites. The new direct enrollment option allows agents to handle the entire transaction. Consumers should compare plans before buying to understand all choices.
  • Consumers who qualify for a subsidy should shop on HealthCare.gov. Those who do not qualify for a subsidy should consider contacting a licensed insurance agent to review all available options.
  • There are two ways to purchase individual insurance, either through the federally run healthcare exchange (healthcare.gov) or via a licensed insurance agent. If you qualify for an individual subsidy, you must purchase your insurance through the Exchange to receive a subsidy.

2018 North Dakota Individual Health Insurance Market

 

Blue Cross Blue Shield of North Dakota

Sanford Health Plan

Medica

Federal Healthcare Exchange

(available at www.healthcare.gov)

 

Available statewide

Sanford TRUE plan – Available in the following counties -Traill, Cass, Oliver, Burleigh and Morton

No plans available

Off-Exchange

(available via a licensed insurance agent)

Available statewide

Available statewide

Available statewide

To help consumers choose the right coverage for themselves and their families, the Department recommends they:

  1. Start early. With more information gathered, smarter decisions can be made.
  2. Stay well-informed. The health insurance landscape is evolving rapidly. What is true today may be outdated tomorrow.
  3. Shop around. What made sense this year may not be the best solution next year, particularly if an employment situation has changed. Take time to shop around and compare prices and plan benefits amongst different insurance companies.

For more information, contact the Department at (800) 247-0560 or visit www.nd.gov/ndins/.



Sanford Health Plan to Remain on the ACA Individual Health Insurance Exchange in 2018
Posted on Wednesday October 25, 2017

BISMARCK, N.D. – Insurance Commissioner Jon Godfread today confirmed that Sanford Health Plan will offer coverage on the Affordable Care Act (ACA) Exchange for individual health insurance plans in some North Dakota counties for 2018. The Sanford TRUE plan will be available for purchase on the Exchange in the following counties – Traill, Cass, Oliver, Burleigh and Morton – while their Simplicity plan will be available statewide off the Exchange. Blue Cross Blue Shield of North Dakota will continue to offer health insurance statewide both on and off the Exchange in 2018, while Medica will only offer coverage through means outside of the Exchange.

“The Insurance Department appreciates Sanford Health Plan and Blue Cross Blue Shield’s commitment to provide health insurance on the federal Exchange to North Dakota consumers following the announcement regarding the non-payment of cost sharing reductions to insurance carriers,” Godfread said. “We are fortunate in North Dakota to still have meaningful competition in our health insurance market, something that does not exist in a number of states across the country.”

Consumers seeking to purchase health insurance on the Exchange will be able to purchase the Sanford TRUE plan from Sanford Health Plan if they reside in Traill, Cass, Oliver, Burleigh and Morton counties. North Dakota consumers who do not receive a subsidy or choose not to purchase insurance on the Exchange will be able to purchase a variety of plans from BCBSND, Sanford Health Plan or Medica through means outside of the Exchange, such as with an insurance agent, in all North Dakota counties.

“The past two weeks have made it abundantly clear that we need health care reform, sooner rather than later. The collective experiences of the Department and the insurance carriers has been one of uncertainty and frustration due to the resistance to reform our broken health care law. This was a situation that could have been avoided and we were hopeful that those in D.C. would come to a resolution. Unfortunately, that is not the case and because of that failure, North Dakotans have been forced to face a marketplace with fewer options in the remaining few weeks leading up to the Open Enrollment Period,” Godfread said. “We have done everything we can at the state level to help insulate our consumers from the collapse of the ACA, it is now up to Congress to address the challenges we are facing and give us meaningful reform to our health care law. I look forward to continuing to work with leaders in Congress as we find solutions that work for North Dakota.”



Insurance Commissioner to Deny Additional Rate Increases Following Non-payments of CSRs
Posted on Monday October 16, 2017

BISMARCK, N.D. – North Dakota Insurance Commissioner Jon Godfread announced yesterday in a live television interview that after careful consideration, following President Donald Trump’s announcement regarding non-payments of cost sharing reductions (CSRs) to insurance carriers, he will deny any additional rate increases to individual health insurance premium rates for Affordable Care Act (ACA)-compliant plans to be offered in North Dakota beginning Jan. 1, 2018.

In a statement to Blue Cross Blue Shield of North Dakota, Medica and Sanford Health Plans, Godfread said, “This decision was made in order to protect the 22,000 covered North Dakotans who have coverage from an individual insurance policy that is off of the federal marketplace along with those on the exchange who do not receive the subsidy. As you know, this is an issue that is between insurance carriers and the federal government and while I understand the strain you are under in participating in this marketplace, it is my duty to look out for those consumers who have had to absorb multiple rounds of increases to their health insurance premiums without receiving any assistance from the federal government.”

As a result of this decision, the approved rates previously released by the North Dakota Insurance Department on Oct. 6, 2017, will continue to be the approved rates for 2018.

Carrier Information

2018 Rate Information

Company Name

Group/Individual

Average Increase

Noridian/BCBS

Small Group

11.8%

Sanford Health Plan

Small Group

2.3%

Medica Health Plan

Small Group

6.2%

Medica Insurance Company

Small Group

8.8%

 

Noridian/BCBS

Individual

22.6%

Sanford Health Plan

Individual

7.9%

*Medica Health Plan

Individual

18.8%

 

*Medica Health Plan will not be selling on the Federal Exchange, meaning consumers who qualify for a subsidy through healthcare.gov will not be able to purchase a Medica policy using a subsidy. Consumers may still purchase a Medica policy outside of the Federal Exchange (for example, through an insurance agent), but would not receive any subsidy to assist in the purchase of the insurance.

Depending upon the plan, health insurance rates will increase by an average range of 2.3-11.8 percent for approximately 30,000 North Dakotans enrolled in an ACA-compliant small group plan. Rates will increase by an average range of 7.9- 22.6 percent for approximately 42,000 North Dakotans enrolled in ACA-complaint individual plans. Approximately 84 percent of North Dakotans are covered by health insurance plans offered through employers that self-insure, participate in “grandfathered” plans purchased before March 2010 or receive benefits from government plans (such as Medicaid, Medicare, Tricare or federal employee plans).

The 2018 open enrollment period runs from Nov. 1, 2017 through Dec. 15, 2017. North Dakotans are encouraged to use this time to compare rates and sign up for new plans or renew existing plans during this period.

For more information, visit www.nd.gov/ndins/.



Insurance Commissioner to Kick Off Medicare Part D Annual Enrollment Events in Grand Forks
Posted on Thursday October 12, 2017

BISMARCK, N.D. – Insurance Commissioner Jon Godfread will kick off a series of eight, statewide Medicare Part D Annual Enrollment Events in Grand Forks on Tuesday, Oct. 17. The event will provide individuals 65 and older with the opportunity to review, plan or shop for coverage options with the assistance of trained, volunteer counselors.

“These annual enrollment events are just one of the valuable services the Department provides to our communities,” Godfread said. “Enrolling in or managing any program as complicated as Medicare Part D can be overwhelming and I’m pleased that we are able to guide North Dakotans through the process. I look forward to joining our talented counselors in my hometown of Grand Forks next week and perhaps, even assisting my own parents in managing their prescription drug plan at this event.”

Open enrollment for Medicare health or prescription drug plans (Part D) runs from Oct. 15 through Dec. 7. It’s just as important for North Dakotans already enrolled in Medicare Part D to review their current coverage during this time as it is for those just enrolling because they can determine what features of coverage matter most to them and shop for plans that meet their needs and fit their budget. For example, changes companies make to their plan’s 2018 formulary (list of approved medications) and the tier assignments may be extremely costly if an individual does not review and make changes to their coverage. Any of the medications covered by a plan in 2017 may not be included in the 2018 formulary; this will result in having to pay full price for the medication.

Individuals needing assistance with enrolling in or managing their Medicare Part D coverage should attend one of the eight, statewide events running from Oct. 17 through Nov. 9 and are asked to bring:

  • A list of medications, including dosages and frequency
  • Medicare card (if applicable)
  • Medicare Part D prescription drug plan card (if applicable)

The State Health Insurance Counseling (SHIC) program hosts the events offering free, confidential assistance to North Dakotans through trained, volunteer counselors. Counselors are trained in all aspects of senior insurance issues, such as Medicare, Medicare part D and Medicare Advantage Plans. The SHIC program is administered by the Department’s Consumer Assistance Division.

“We’re very fortunate in North Dakota to have the opportunity to provide this service to the state through the State Health Insurance Counseling program,” David Zimmerman, Consumer Assistance Division Director, said. “Our volunteer counselors are committed to providing the highest quality of unbiased information to North Dakotans at absolutely no cost.”

Click here to view all of the dates and locations for the annual enrollment events.

For more information, visit www.nd.gov/ndins/shic or call (701) 328-2440.



Insurance Department Releases Approved ACA Health Insurance Premiums, Encourages Consumers to Shop
Posted on Thursday October 05, 2017

BISMARCK, N.D. – The North Dakota Insurance Department today announced the approved health insurance premium rates for Affordable Care Act (ACA)-compliant individual and group plans to be offered in North Dakota beginning Jan. 1, 2018.

“When reviewing the rates submitted by North Dakota health insurance companies, it was evident that the heavy burdens created by Obamacare are continuing to force rates to significantly increase as time goes on,” Godfread said. “However, we are fortunate in North Dakota to have competition in our individual and group markets giving our consumers the opportunity to shop around. As open enrollment periods for 2018 approach, it is important for North Dakotans to shop amongst the three health insurance companies selling in our state to make sure they find health insurance that fits their needs at the best price. I will continue to advocate for long term solutions that lower the cost of coverage and increase competition in North Dakota’s health insurance marketplace.”

Carrier Information

2018 Rate Information

Company Name

Group/Individual

Average Increase

Noridian/BCBS

Small Group

11.8%

Sanford Health Plan

Small Group

2.3%

Medica Health Plan

Small Group

6.2%

Medica Insurance Company

Small Group

8.8%

 

Noridian/BCBS

Individual

22.6%

Sanford Health Plan

Individual

7.9%

*Medica Health Plan

Individual

18.8%

 

*Medica Health Plan will not be selling on the Federal Exchange, meaning consumers who qualify for a subsidy through healthcare.gov will not be able to purchase a Medica policy using a subsidy. Consumers may still purchase a Medica policy outside of the Federal Exchange (for example, through an insurance agent), but would not receive any subsidy to assist in the purchase of the insurance.

Depending upon the plan, health insurance rates will increase by an average range of 2.3-11.8 percent for approximately 30,000 North Dakotans enrolled in an ACA-compliant small group plan. Rates will increase by an average range of 7.9- 22.6 percent for approximately 42,000 North Dakotans enrolled in ACA-complaint individual plans. Approximately 84 percent of North Dakotans are covered by health insurance plans offered through employers that self-insure, participate in “grandfathered” plans purchased before March 2010 or receive benefits from government plans (such as Medicaid, Medicare, Tricare or federal employee plans). Today’s announcement will not affect the rates for these consumers.

A company requesting a rate increase must provide information satisfactory to the Department justifying the level of the requested increase. The Department reviews a number of factors that affect the overall increase in the cost to provide health care services, including:

  • Increased use and cost of services to consumers
  • Benefit changes 
  • Administrative expenses for the companies
  • Government mandates, benefits and other legislative changes
  • Increased costs due to federal health care reform

The Department also reviews historical (actual) experience to date, including previous rate increase request amounts, frequency and results. After carefully reviewing all the submitted information, the Commissioner can approve the requested amount, offer a lower increase or deny the request. The entire process of reviewing, analyzing and making a decision on rate increase requests typically takes the Department two months.

The 2018 open enrollment period runs from Nov. 1, 2017 through Dec. 15, 2017. North Dakotans are encouraged to use this time to compare rates and sign up for new plans or renew existing plans during this period.

For more information, visit www.nd.gov/ndins/.



Medica Leaving North Dakota Individual Health Insurance Exchange in 2018
Posted on Wednesday September 27, 2017

BISMARCK, N.D. – Insurance Commissioner Jon Godfread today confirmed that the Insurance Department was informed late Wednesday, Sept. 27, that Medica does not intend to sign an agreement with the federal government to offer coverage on the Affordable Care Act (ACA) Exchange for their individual health insurance in North Dakota for 2018.

“We have had numerous conversations with Medica over the course of the past few months, and given the uncertainty that currently exists around cost sharing reductions, they are unable to move forward in the Federal Exchange,” Godfread said.

Cost sharing reductions (CSRs) are payments made by the federal government to insurance carriers to help low-income consumers with out-of-pocket costs, such as co-payments and deductibles. Recent health care debates have included consideration by the federal government to not provide CSRs to carriers. After originally making the decision to file rates with CSR funding included, Medica has now requested that the Department approve premium rates for 2018 assuming CSRs would not be paid, which would have led to an additional increase in those rates, on top of the initial rate increase already being requested by Medica.

The Department has declined to approve any rates requested under this assumption.

“Although we understand Medica’s concerns regarding the uncertainty of CSR funding, without knowing the intentions of Congress regarding CSRs, we had to make the decision to move forward with rates that assumed payments would be made,” Godfread said. “If the Department approved rates requested by Medica excluding CSR payments, and Congress does fund those payments, it is unknown if the Department would then be able to reduce the rates to reflect the changes made. With this in mind, the Department felt it was our responsibility to err on the side of caution and protect North Dakota consumers from any unnecessary increases. The decision made by Medica, illustrates that North Dakota will not be insulated from the collapse of the ACA, and our consumers who purchase health insurance on the federally run exchange will now face fewer options.”

North Dakota consumers will still be able to purchase an individual health insurance plan from Medica through means outside of the ACA Exchange, such as with an insurance agent versus the Healthcare.gov website. Consumers seeking a subsidy for their health insurance will be unable to purchase plans from Medica on the federally run exchange.  Of the 20,691 individuals on the Exchange, Medica provides coverage for 3,073.

“This situation is one the Department understood to be a possibility but we were hopeful that Congress would come to a resolution regarding health care reform and that we would have more answers at this point. Unfortunately, that is not the case and because of that failure, Obamacare has continued to crumble. Medica’s decision further illustrates just how unstable the ACA Exchange is and will hopefully be a reminder to Congress that Obamacare is indeed in a death spiral. It is no longer sustainable and now North Dakotans are not only facing higher rates, but also fewer options,” Godfread said.



Insurance Commissioner Provides Recommendations to Senate Committee on Health, Education, Labor and Pensions
Posted on Sunday September 10, 2017

BISMARCK, N.D. – Insurance Commissioner Jon Godfread, sent a letter Friday to Senate Committee on Health, Education, Labor and Pensions Chair, Senator Lamar Alexander (R-TN), in response to a request for recommendations on legislative changes to give states additional flexibility in stabilizing their individual market and developing broader state-based insurance coverage reforms. The request was made by Chairman Alexander in preparation for an upcoming committee hearing on Sept. 12.

“I appreciate the opportunity to provide the Committee with recommendations on health care reform and believe it is in the best interest of consumers across the nation that insurance regulators be an integral part of this discussion,” Godfread said. “Regulators are currently facing an uncertain and unpredictable marketplace which is causing an unprecedented increase in premiums to the detriment of our consumers. We must be given the flexibility to better tailor the health insurance market to the needs of our consumers.”

Chairman Alexander also requested a recommendation for possible legislative actions that could be taken in order to stabilize individual insurance premiums for the 2018 plan year, along with feedback on the Section 1332 State Innovation Waiver. Section 1332 of the Affordable Care Act (ACA) permits a state to apply for a waiver to pursue innovative strategies for providing their consumers with access to high quality, affordable health insurance while retaining the basic protections of the ACA.

The Committee will hold a series of bipartisan hearings focused on stabilizing insurance premiums and helping those in the individual insurance market in the 2018 plan year.

The here to read the letter.



Insurance Department Receives Accreditation at NAIC Summer Meeting
Posted on Wednesday August 16, 2017

BISMARCK, N.D. – Insurance Commissioner Jon Godfread, along with six other Insurance Department employees, joined insurance regulators from across the U.S. last week for the National Association of Insurance Commissioners (NAIC) summer meeting in Philadelphia, PA. The Department was one of four state insurance regulatory agencies to receive accreditation from the NAIC Financial Regulation Standards and Accreditation Committee at the meeting.

The NAIC accreditation program establishes and maintains sound solvency regulation standards. It provides for the effective regulation of multi-state insurance companies with emphasis on each state’s:

  • Financial solvency laws and regulations;
  • Financial analysis and examination capabilities;
  • Organizational and personnel practices; and
  • Insurer organizational review, licensing and change of control of domestic insurers.

Accredited insurance departments undergo a comprehensive, independent review every five years to ensure they meet financial solvency oversight standards.

“I’m very proud of the Department’s accreditation team for attaining this achievement,” Godfread said. “This group of people has worked tirelessly to ensure that the Department be recognized for its continued dedication to providing the highest quality of service to North Dakota consumers and providers. This is a great milestone in our ongoing evolution as a state agency.”

Along with accreditation program awards, the NAIC summer meeting agenda included speakers, committee and task force meetings, and forums for discussion on all areas of the insurance industry and its regulation. NAIC President Ted Nickel shared his pride in the work being done by state regulators stating that the U.S. has the largest and most vibrant insurance marketplace in the world, healthy competition in most lines of business and a regulatory system which has withstood the dual tests of time and crisis. Nickel added that regulators must look toward the future with a purpose as they’re facing a tidal wave of change like nothing experienced in the history of insurance before.

One way in which the NAIC is helping North Dakota address this impending radical change is through a strategic planning policy initiative called “State Ahead.” The initiative is a roadmap for the next five years focusing on making improvements in the areas of safe and solvent markets, consumer protection and education, and NAIC member services and resources. As part of the State Ahead initiative, perhaps no other issue is as much at the forefront as innovation and technology. Through the Innovation and Technology Task Force formed earlier this year, the NAIC is working to understand how new technologies impact the insurance marketplace while exploring benefits to consumers, industry and regulators. Godfread represents North Dakota on the 27-member task force.

“The task force continues to monitor and encourage the development of a cybersecurity insurance market that will protect policyholders as well as drive best practices in data protection,” Godfread said. “When data is properly managed, it can improve how an insurer does business and benefits consumers. This is a goal the task force is diligently working toward.”

Health care reform was another topic of interest dominating much of the conversation at the summer meeting. Ongoing political gridlock in Washington continues to create uncertainty for consumers and markets. While state regulators work hard to ensure some measure of stability and residency, carriers are pulling out of individual markets across the nation and it is possible there will be counties, and perhaps even states, with no policies available on the Exchange in 2018. North Dakota, however, will continue to have three insurance companies offering policies on the individual market.

Finally, the summer meeting spotlighted the NAIC’s partnership with entertainer Rita Moreno. Moreno’s campaign brings attention to the importance of retirement security through early planning and making financial decisions beneficial to individuals and their families. A new public service announcement (PSA) featuring Moreno has been distributed to TV stations nationwide. The PSA gives viewers a look at a day in Moreno’s life and is rooted in her life motto – “keep moving.”

The NAIC is the U.S. standard-setting and regulatory support organization created and governed by the chief insurance regulators from the 50 states, the District of Columbia and five U. S. territories. Through the NAIC, state insurance regulators establish standards and best practices, conduct peer review, and coordinate their regulatory oversight. NAIC conferences are conducted at the expense of the NAIC and funding is provided to states to offset the cost of employee travel.



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