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NAIC Lists Risk Pool Adopters

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At least 31 states plan to operate their own transitional high-risk pool health coverage programs, according to the National Association of Insurance Commissioners.

The NAIC, Kansas City, Mo., has posted a list of the states in the new health reform section on its website.

The NAIC also has posted a list of 18 states that have decided to let the U.S. Department of Health and Human Services provide alternative programs for residents with health problems in their jurisdictions.

Two states – Arizona and Utah – are not yet sure what they want to do about risk pools.

The new Affordable Care Act — the legislative package that includes the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act – will require health insurers to offer individual coverage on a guaranteed-issue basis, without adjusting the price of coverage to reflect the insured’s health status, in 2014.

Before then, states can apply for a share of $5 billion in federal funding allocated for risk pool programs, or other programs, that will cover uninsured people who cannot buy conventional coverage because they have health problems.

A state that already has a risk pool program can cover eligible uninsured, high-risk individuals by setting up a second risk pool program alongside the existing program, according to the NAIC.

The cost of the new risk pool coverage can be no more than 100% of the standard non-group rate, and the cost of coverage for the oldest insureds can be no more than 4 times the cost of the cost of coverage for younger insureds.


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