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Life Health > Health Insurance > Your Practice

PPACA: Colorado Tackles Child-Only Antiselection Fears

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The Colorado Division of Insurance has responded to insurers’ fears about the effects of new federal health insurance underwriting rules by setting an open-enrollment period schedule for child-only coverage.

The first open-enrollment period for Colorado child-only coverage started Thursday and will continue until Oct. 31.

Beginning in 2011, there will be one open-enrollment period each January and one in July, division officials say.

Children can buy coverage during the open-enrollment periods on a guaranteed-issue basis, without any limitations or riders based on health status, but there will be no federal limits on the rates carriers can charge for the coverage, officials say.

Children also can enroll in coverage on a guaranteed-issue basis after qualifying events, such as birth, adoption or loss of other coverage.

The open-enrollment periods will be open to Colorado children ages 18 and younger.

The Colorado division set up the child-only open-enrollment schedule in response to provisions in the Affordable Care Act, the federal legislative package that includes the Patient Protection and Affordable Care Act (PPACA), that will prohibit carriers that offer child-only coverage from consider pre-existing conditions when deciding whether to sell health coverage to a child.

The provision is taking effect for health insurance and health plan years starting on or after Thursday.

Insurers have warned that letting parents of children with health problems sign up for coverage at any time, without

facing underwriting restrictions, could encourage parents to buy coverage during months when their children seem likely to need care, then drop the coverage as soon as the imminent need for care passes.

Officials at the U.S. Department of Health and Human Services (HHS) have indicated that they are open to the idea of letting states use scheduled open-enrollment periods to discourage parents from paying for health coverage only during months when their children seem likely to need care.

Several large carriers said the potential for severe adverse selection would force them to suspend sales of child-only coverage.

Colorado Insurance Commissioner Marcy Morrison says she hopes the new open-enrollment schedule will help promote broad access to child-only health coverage.

“Without defined open enrollment periods, Colorado consumers may be left with few choices for insurance coverage for children with pre-existing conditions,” Morrison says in a statement.

Morris is using an emergency regulation to establish the open-enrollment schedule.


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