New Hampshire Insurance Commissioner Roger SevignyQ: What challenges do you anticipate your particular state running into with upcoming health care reform provisions?

Roger Sevigny: The biggest challenge is implementing the reforms in a small state with a small insurance market; issues such as adverse selection become particularly important. In addition, the federal law requires additional administrative requirements in the creation of an exchange, transparency of information, and consumer assistance. There will be costs in implementing and maintaining the new administrative infrastructure required under federal law.

We anticipate no rating challenges at this time, but our anticipated form-filing challenges include volume in a short period of time, administrative costs, and the delay of non-ACA [Affordable Care Act] filings.

Another challenge will be creating an effective consumer education and outreach program.

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

RS: The biggest question is what the market will look like and how competition will drive innovation in the future. With essential benefits yet to be defined, the innovation will move on the delivery (provider) side of the equation.

The role of producers will change. The federal requirements for an exchange require a navigator function, a premium calculator, and comparative information on the cost and quality of plans. Producers will need to change their way of doing business and focus on their value-added component.

Q: What should producers concentrate on the most over the next 10 or years with regard to health care reform’s affects in New Hampshire?

RS: Producers should concentrate on the education of themselves and their clients, and access and support the exchange concept to understand their value-add. Producers should also concentrate on how their roles will change and what services they can provide to a restructured system.

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

RS: New Hampshire is working with other state agencies on implementing state reforms. Because we are a small state, the insurance department is able to solicit input and meet with a number of interested parties. The department recently issued a request for comment-seeking input on a number of questions related to exchanges. As the process moves forward, the department will involve interested groups and persons in the implementation process.

  • We’ve applied and received a $1 million grant related to the rate review process. This may lead to doing things differently, but nothing is anticipated at this time.
  • Also, through the rate review grant, we will enhance consumer protection by making the rate review process and results more transparent to the consumers. This includes complying with new federal reporting and oversight requirements.
  • We have issued, via bulletins, standardized certificate amendments which in effect deems health care policies sold in New Hampshire to be compliant with the new reform providing consumer protection.
  • New Hampshire has applied and been granted $1 million for the purpose of evaluating and planning for an exchange in New Hampshire.
  • New Hampshire has applied for grant funds to expand both the capacity and scope of consumer assistance services offered by the New Hampshire Insurance Department through the addition of a health insurance consumer advocate and to contract with nonprofit entities to provide consumer education and outreach services, through the Consumer Assistance Program Grant.

Q: What did you get out of President Obama’s recent meeting with several state regulators?

I did attend, and it was a meeting to recognize the importance of state regulators in the process.

Roger Sevigny leads a staff of 81 employees and is an active member of the NAIC, currently serving as the past president and as chair of the market regulation and consumer affairs (D) committee, as well as several additional councils, groups, and task forces. Prior to his appointment as commissioner, he held the position of assistant commissioner of New Hampshire’s Insurance Department. Before joining the Insurance Department, he was an employee of Travelers Insurance for more than 30 years.

More state insurance regulator Q&As:

Alaska

Arkansas

Illinois

Indiana

Iowa

Kansas

Kentucky

Maryland

Minnesota

Nevada

Nebraska

North Carolina

North Dakota

South Dakota

South Carolina

New Hampshire Facts At-A-Glance

New Hampshire

United States

Demographics

Total population

1,305,000

303,343,300

Median annual income

$66,654

$49.945

Health costs and budget

Health spending per capita

$5,432

$5,283 (by state of residence)

Average employee contribution for family premium (% of total premium)

26%

27%

Health coverage

Uninsured population (% of total population)

10%

17%

Uninsured children (% of children)

4%

10%

Medicaid enrollment (% of total population)

11%

19%

Medicare enrollment (% of total population)

16%

15%

Monthly CHIP enrollment, June 2009

7,905

4,966,030

Health status

Infant mortality rate (per 1,000 live births)

5.6

6.8

Teen death rate (per 100,000 population)

43

62

AIDS diagnosis rate (per 100,000 population)

2.1

12.3

Overweight or obese children (% of children)

29.4%

31.6%

Adults who visited the dentist/clinic (% of adults)

76.7%

71.3%

Adults with disabilities (% of adults)

11.3%

12.1%

Source: Kaiser Family Foundation State Health Facts