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Life Health > Health Insurance > Health Insurance

Pennsylvania Still Looking For Risk Pool Manager

By staff Writer

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The Pennsylvania Insurance Department is hiring an administrator to run a new health insurance program for state residents with health problems.

The federal Affordable Care Act (ACA) – the legislative package that includes the Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act – is set to ban use of health status information in the individual market starting with plan years that begin in 2014.

Between Thursday and 2014, managers of the ACA risk pool program will try to help individuals who are unable to buy ordinary health coverage because they are considered uninsurable by helping them get subsidized coverage from a new temporary risk pool program.

Some states already have risk pool programs, but many are closed to new members, and many offer very expensive coverage, or coverage with tightly limited benefits.

The ACA temporary risk pool program will be available to people who have a pre-existing medical condition and have been uninsured for 6 months or more. Rates are not supposed to vary by age by a ratio greater than 4 to 1, and rates are not supposed to be higher than the cost of standard health coverage.

Some states have applied to run their own risk pool programs, and others will be letting the federal government handle the job.

The federal government has approved Pennsylvania’s application to offer its own risk pool program, Pennsylvania Insurance Commissioner Joel Ario says.

The state will get $160 million in funding for the pool, and the pool could provide coverage for about 5,600 Pennsylvania residents, Ario says.

“The plan’s benefit package will include preventive care, physician services, diagnostic testing, hospitalization, mental health services, prescription medications and much more, with subsidized premiums of $283 a month,” officials say.

Pennsylvania officials have posted the solicitation for the pool administrator on the Web.

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