OHIC: Short-term health plans not approved for sale in R.I.

R.I. HEALTH INSURANCE COMMISSIONER Marie Ganim noted that short-term health plans are not approved for sale in Rhode Island, despite a federal rule expanding access to the limited health care option. / PBN FILE PHOTO/ RUPERT WHITELEY

PROVIDENCE – The Trump Administration’s plan to expand access to short-term, limited duration health plans which omit coverage mandated by the Affordable Care Act won’t affect Rhode Island’s ban on the plans, according to the Office of Health Insurance Commissioner.

The plans were intended for individuals who experience a gap in insurance coverage. They are excluded from consumer protections spelled out in the ACA, including requirements that prohibit medical underwriting, pre-existing condition exclusions, lifetime and annual limits, as well as minimum coverage standards, according to the Henry J. Kaiser Family Foundation.

The plans usually only provide coverage for less than a year, and they are not renewable. “As a result, an individual who buys a short-term policy and then becomes seriously ill will not be able to renew coverage when the policy ends, according to the foundation.

Marie L. Ganim, Rhode Island’s health insurance commissioner, said that though the plans are not approved for sale in Rhode Island, underwriters continue to call people in the state and sell the plans.

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A few people who have bought the plans have contacted her office, she said, when claims made are not approved for payment by the unauthorized plans. In those cases, she said, OHIC works with their consumer assistance partner, the Rhode Island Parent Information Network, to resolve the claim. But if a resolution isn’t possible, she said, the consumer is on the hook for the bill.

“We are very concerned about the increased marketing of these short-term plans to unsuspecting Rhode Islanders, who think they are paying for real health coverage but in fact are only getting junk insurance. With this latest action, the Federal Administration continues to undermine the work Governor Raimondo has done to ensure full implementation of the ACA in RI,” said Ganim.

The final rule released by CMS.gov on Wednesday allows people to buy short-term plans that are available for less than a year, contain language explaining the coverage provided, and can be renewed for up to 36 months.

“In the final rule, we also strengthened the language required in the notice and included language deferring to state authority,” the CMS states in its fact sheet on the new short term limited duration insurance rule.

The new rule doesn’t change Rhode Island’s stance on the limited plans.

“This new federal rule does not restrict state authority to regulate these plans. OHIC has broad statutory authority to protect the best interest of consumers, and certainly the marketing of deceptive health insurance that does not meet state minimum coverage or anti-discrimination requirements is not in the public’s interest. Therefore, none of these plans are currently approved for sale in our state,” Ganim said.

Rhode Islanders with questions or concerns about health plans being sold to them can call OHIC’s consumer assistance partner, RIPIN, at 401-270-0101.

Rob Borkowski is a PBN staff writer. Email him at Borkowski@PBN.com. 

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