State Legislative Information

 HUPAC | GAHUPAC | Operation Shout

Market/Provider Issues

Third Party Provider:  GAHU supports the work of the Insurance Commissioner to protect consumers who have been caught in situations where they have done all the right things in seeking care of network providers in network facilities only to find that non-network providers contracted with the facility are balance billing.  We support his pledge to adopt new law/regulation as needed to extend these protections to all insured Georgians, not just to those who happen to contact the Commissioner’s Office.

Extension of Access:  GAHU supports the idea that currently subscribed consumers should be protected in situations such as failure of provider contract negotiations or provider contract termination.  Access to network providers under current contract provisions should continue for insured individuals at least until the insurance policy reaches its next renewal period.

Transparency:  GAHU believes that one of the most important things that we can accomplish to protect the interests and safety of Georgians is to make providers accountable to consumers in delivery of healthcare services and that they should be required to compete on outcomes and performance as well as pricing of their services.  We believe that informed consumers make wiser healthcare choices and that they act more responsibly when they know the true cost of their healthcare services.  Lack of accountability of providers and insurance consumers is one of the greatest drivers of cost in our delivery system.  More accountability and transparency will enable us to insure more Georgians and improve their health outcomes in the future.

Certificate of Need:  GAHU supports fair, safe and efficient markets for healthcare services and increased competition among providers for revenue from healthcare consumers.  We support increased accountability and outcomes measures in CON review, both for new applicants and those who are renewing or expanding services to the market.  Providers should be required to face competition based on these accountability measures in order to retain any permitted market dominance or exclusivity in a service area that is a result of certification.

Market Stabilization/Transformation/Expansion Issues

High Risk Pool:  Georgia must be removed from the terribly short list of states that has no mechanism for covering medically uninsurable individuals.  Establishment of a High Risk Pool or Assignment Pool Underwriting Authority (HRP/APUA) is too essential a matter of public policy for this state not to become a reality.  All the other work we do relating to the health/transformation of the market absolutely depends on a pool for stability of the individual and small group markets.  Uninsurable individuals who want to take responsibility for their healthcare and pay their share of costs for coverage have waited long enough.  This matter has been discussed and studied enough.  It is time for action!

Taxation Issues

Premium Tax:  GAHU supports reduction and potential future elimination of the Premium Tax as a means of reducing the overall cost of coverage and as an economic/market development incentive for insurers to do business and base their operations in Georgia.

Health Insurance Tax Exemption:  We support the Insurance Commissioner’s desire to eliminate taxation (income and premium tax) of health insurance premiums, but we also support efforts by Georgia Public Policy foundation (GPPF), Center for Health Transformation (CHT) and others for elimination of taxation of premiums for High Deductible Health Plans (HDHPs) as a positive step if budgetary restraints impede passage of a broader tax exemption for all health plans.

Market Information Accessibility—“The Exchange” –“Travelocity”:  GAHU supports the concept of increased access for consumers to information on health plan choices in the individual and small group markets.  We support such initiatives and access models that reflect and facilitate access to the current market, not those that radically alter the market or replace it in the process.  We oppose employer mandates for participation in a “connector” or “exchange” for purchase of coverage and differentials in rates and plan design for products offered to the market in such arrangements.  We also strongly affirm the importance of the agent/customer relationship and will defend the right for employers and families to obtain the best service, rates and access regardless of participation in any new marketing model.

Cross-State Sale of Health Plans:  GAHU supports the concept of allowing cross-state sale of health plans as an incentive for access for consumers in Georgia and neighboring states.  We do caution that consumer interests must be protected and insist that Georgia based agents have access to offer any such permitted plans in Georgia.  We also insist that clear and uniform accountability standards apply and Georgia consumers and agents have standing to bring complaints and grievances to regulators regardless of the state in which a plan is licensed.

Regulatory/Implementation Issues

Agent Status Issues: 

Agent of Record:  GAHU advocates adoption of a uniform Agent of Record Letter for the small group market.  Many employers have been confused or misled by unscrupulous use of AORLs that do not clearly explain their purpose and meaning.  The rationale for a uniform AORL is to make sure the employer is adequately informed of the letter’s meaning and its implications for the relationship with their agent.

Rebating:  GAHU advocates uniformity and clarity in interpretation of existing laws and regulations that bear on unfair or deceptive business practices related to rebating and the increased use of discounted or free services that are not part of the insurance contract as inducements for business.  GAHU supports revision/updating of laws and regulations if deemed useful in preventing abuse and unfair trade practices in the delivery of health insurance and employee benefits.

Small Group Disincentives/Health Status on Renewal:  We support the Insurance Commissioner’s recent work in requiring retention of agent quote requests for the small group market and his stance on fairness of employer access to small group health plan market.  We have pledged to work with the Commissioner on adoption of uniform regulations to apply the retention requirement across the entire market and to evaluate the potential impact of potential new regulatory allowance for use of health status in renewal rating.

Long Term Care

Long Term Care Partnerships:  LTCP will open up new, fresh markets for consumers for affordable Long Term Care Insurance (LTCi) products.  We are proud of our leadership in passage of this important legislation and will continue our involvement as the regulations, training requirements, and carrier involvement in this new market opportunity emerge in coming months.  We do not foresee dramatic additional legislative actions as a requirement, but we are committed to working with the state agencies and the federal regulators to speed products to market and improve the lifelong planning prospects of all Georgians.

Long Term Care Insurance - Own Your Own Future:  We support the Governor’s advocacy and educational approach to Georgians through the “Own Your Future” campaign in regard to Long Term Care and Long Term Care Insurance.  We offer our members’ expertise in helping to provide information through Town Hall meetings and other forums wherever practicable.