States To Tackle Health Insurance Regulation In 2019, Consultant Says

If there’s one bit of advice for health and benefits brokers in the coming year, it’s look to the states.

That’s the word from Chase Cannon, vice president and deputy chief compliance officer of NFP, an insurance broker and consultant providing employee benefits through a network of affiliates.

A December federal court decision ruled the Affordable Care Act “invalid,” with a judge determining that the 2017 tax cut bill knocked the constitutional foundation from under the health care bill by eliminating the individual mandate penalty.

While the future of the ACA is up in the air, states and even some cities are stepping in with their own laws to keep people in coverage, Cannon said.

New York City Mayor Bill de Blasio introduced an option called New York City Care with the goal of getting everyone in the city enrolled in health coverage, even undocumented immigrants, Cannon said.

“Other states are enacting or contemplating their own individual mandate,” he said. “Some states are thinking, if the ACA is struck down or the individual mandate is struck down, why don’t we enact our own individual mandate? New Jersey did that and other states are looking at it.”

If states are going to enact their own laws regarding health coverage, “it’s really going to create a challenge,” Cannon said.

“You’ll get this patchwork of laws across different states. Maybe the idea is the same but the details can create a lot of questions. What’s the level of coverage you will require? Do all employer plans count? What about limited benefit plans, do they count? How will your citizens verify they have coverage?”

This will creates problems for employer groups and for anyone in the industry who needs to understand what is required under a set of new laws, he said.

'Huge Challenge'

More states also are enacting their own laws regarding paid sick leave, which creates challenges for the group health and benefits market.

“Particularly for multistate employer groups, they have a huge challenge on educating themselves on the new rules as well as implement changes to their leave policies. This will impact their benefits as well,” Cannon said. “Being able to understand and implement a leave program that that takes these laws into account can be a real challenge.”

Wellness programs represent another area in which employers and benefit brokers must look out for in 2019, Cannon said.

Wellness programs fall under the purview of several different laws such as federal privacy laws or the Americans with Disabilities Act. Cannon said employers who implement wellness programs will need advice from brokers on whether something like putting a health insurance surcharge on an employee or testing workers’ blood for biometric levels and tying that into the group health plan is legal.

“Brokers need to understand how things coming down from regulatory agencies and from the courts  will impact how employers will offer benefits to their employees,” he said.

Susan Rupe is managing editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected]. Follow her on Twitter @INNsusan.

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Susan Rupe is managing editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected].