Q: What challenges do you anticipate your particular state running into with upcoming health care reform provisions?

Linda Hall: As a small marketplace, Alaska will face challenges with the minimum loss ratio and rebate portions of the health reform law. These elements have the potential to destabilize our marketplace. Alaska continually faces increases in the cost of health care, and the mandates in the reform act may increase these costs even further.

Q: For producers licensed to sell health insurance in your state, what developments might they look out for, both in the short term and long term?

LH: Producers need to recognize that the medical loss ratio requirements will place constraints on the expense component of health insurance rates, and this will likely result in commission reductions. It would seem that brokers need to move toward some type of fee agreement as compensation for services they provide. Brokers should be working to supply value beyond the commissions received for sales activities and to educate the public regarding after sales services, such as claims assistance, that they furnish. They may also want to consider how they can fill the role of the “navigator” as provided in the federal law and how they can protect their role as insurance exchanges are developed.

Additionally, producers might consider lobbying Congress to recognize the value in the services they perform, especially the “after sales” services, and to find a way to ensure that adequate compensation is permitted.

Q: Is your state doing anything differently or preparing in any special way for health care reform?

LH: Alaska will request a waiver from the individual market medical loss ratio, as we feel this will have a significant negative effect on the individual health insurance market in Alaska. Alaska is also trying to use state funds and resources to comply with the provisions of the health reform law, as opposed to relying on federal funds.

Q: What did you get out of the meeting President Obama recently held with several state regulators?

LH: This meeting was an opportunity to begin to develop a working relationship with the administration, and I appreciated the open dialogue that occurred as the president took questions from regulators and answered candidly.

Gov. Murkowski appointed Linda Hall as director of the Division of Insurance in the Department of Community and Economic Development in Alaska on March 3, 2003. She has 18 years experience in the insurance industry as a commercial broker and served as the chair of the Alaska Workers’ Compensation Review and Advisory Committee, and is a past president of the Alaska Independent Insurance Agents and Brokers.

More state insurance regulator Q&As:

Arkansas

Illinois

Indiana

Iowa

Kansas

Kentucky

Maryland

Minnesota

Nevada

Nebraska

New Hampshire

North Carolina

North Dakota

South Dakota

South Carolina

Alaska Facts At-A-Glance

Alaska United States
Demographics
Total population 666,900 303,343,300
Median annual income $63,505 $49.945
Health costs and budget
Health spending per capita $6,450 $5,283 (by state of residence)
Average employee contribution for family premium (% of total premium) 29% 27%
Health coverage
Uninsured population (% of total population) 19% 17%
Uninsured children (% of children) 12% 10%
Medicaid enrollment (% of total population) 18% 19%
Medicare enrollment (% of total population) 9% 15%
Monthly CHIP enrollment, June 2009 8,721 4,966,030
Health status
Infant mortality rate (per 1,000 live births) 6.5 6.8
Teen death rate (per 100,000 population) 100 62
AIDS diagnosis rate (per 100,000 population) 3.2 12.3
Overweight or obese children (% of children) 33.9% 31.6%
Adults who visited the dentist/clinic (% of adults) 66.3% 71.3%
Adults with disabilities (% of adults) 12.0% 12.1%

Source: Kaiser Family Foundation State Health Facts