Managers of the state-based Maryland Health Connection have been thinking about how insurance for carriers will work next year.
Managers are thinking about providing enough supplement reinsurance to make sure health insurers get enough reinsurance money to compensate for 80 percent of the cost of eligible reinsurance-covered catastrophic claims.
Outside consultants have told the board that offering that much supplemental reinsurance could help reduce premium costs by 2.9 percent.
One challenge is that the consultants aren’t sure how what an influx of previously uninsured patients with serious health problems might do to claim costs.
The consultants estimate it might boost costs by 10 percent.
Another challenge is that the consultants still aren’t sure how the U.S. Department of Health and Human Services will run its part of the reinsurance program in 2015, according to a presentation included in a Maryland exchange board meeting packet.
The Patient Protection and Affordable Care Act now requires carriers to sell coverage to consumers who apply during open enrollment periods, or who qualify for special enrollment periods, on a guaranteed-issue basis.
Carriers that sell PPACA-compliant individual plans must offer coverage to eligible people who are about to get heart transplants for the same price they offer coverage to people in top condition.