According to recent press, the federal government has indicated that it plans to decrease the premiums for the federal PCIP (temporary risk pools) by 20% in order to encourage greater enrollments.
Apparently enrollment in the new PCIP has been lackluster at best.
I do not yet know if the decrease will be applied to the CA PCIP as it is being run by the state (MRMIB) and not a direct federal risk pool.
Unless the government can find more $$$ to pump into the pools, this is going to likely create a reduced number of enrollment slots meaning less people will be able to be covered at the lower premium.
California's PCIP is scheduled to hold an average of 23,100 people at any given time with a possible increase in two years if scheduled federal funding is available. Obviously a 20% premium decrease under existing funding ($761MM) would likely lower the number of subscribers by that same percentage.
PCIP Premium Decrease (HHS)
California PCIP (Federal Risk Pool) Delays Open to October 7
The California PCIP (Pre-existing Condition Insurance Program) has announced a delay of one week for opening of the coverage program.
MRMIB anticipates coverage to go into force on October 7, 2010.
California PCIP (Federal Risk Pool) Opens
The PCIP (Pre-existing Condition Insurance Program), also referred to as the Federal Temporary Risk Pool, is now open and accepting applications for enrollment.
The PCIP is an individuals-only enrollment with no dependents. Rates are set correspondent to the standard rate for a similar $2500 deductible PPO plan on the open market in California. PCIP will use a larger network of providers than MRMIP, approximately 65,000 should be available. The PCIP plan offers both in-network participating benefit levels and and out-of-network non-participating benefit levels.
Applications received by the 10th of the month will be enrolled for the first of the following month.
According to MRMIB, which will run the program for California, agents may assist applicants in the enrollment process for PCIP and receive a $50 fee the same as currently available on the MRMIP program.
Eligibility for the PCIP consists of the following:
1. California state residency as evidenced by applicant having a California address or other appropriate documentation as determined by MRMIB
2. US Citizenship and immigration status for applicants obtained through questions and supporting documentation
3. Applicant has a pre-existing health condition as evidenced by a denial letter from a health insurer or acceptance in a health plan which has rates in excess of PPO rates in the MRMIP (state risk program)
4. Applicant has been without creditable coverage for a least 6 months prior to applying for the PCIP
The California PCIP intends to provide enrollment to an estimated 23,000 California residents. By comparison, MRMIP, the state major risk plan, enrolls a maximum of 7,100. If the PCIP is a maximum enrollment in 2012, the federal government may grant additional funds to the CA PCIP to increase enrollments.
I will place a PCIP application on my web site as soon as it is available for download from MRMIB. It will be available here
Here is the final BROCHURE for the California PCIP including plan summary and rate guide.
PCIP Getting Closer in California
The PCIP (Pre-existing Condition Insurance Plan)aka Federal Risk Pool will be opening for enrollment in a few weeks.
MRMIB has published some very basic information including a rate guide summary for the PCIP in California.
You can view the summary including the proposed rates here.
Currently you may request an application be sent to you once they are available by sending an e-mail request to PCIP@mrmib.ca.gov
As of today there is no information on plan benefit design nor which carriers will offer plans.
CA Temporary Federal Risk Pool Approved
Yesterday, two legislative bills were passed in Sacramento which will allow for California to run a temporary risk pool using federal funds (under PPACA). The risk pool will provide coverage on a temporary basis until January, 2014.
The two bills, SB 227 (Alquist) and AB 1887 (Beall) will provide both parity for mental health and substance abuse (AB 1887) as well as the temporary risk pool for uninsurable California residents (SB 227). Passage of SB 227 was predicated on prior passage of AB 1887.
California will receive $761,000,000 of federal funds for the risk pool. State sources indicate that the risk pool will not use any California state funds.
Details including qualification requirements, insurance plans (will be PPO style) and rates should be forthcoming from the MRMIB. MRMIP will run the program alongside the state major risk program.
MRMIB Moving Forward on Fed Risk Pool
MRMIB (California's Major Risk Medical Board) is putting together the federal major risk pool program for California. According to the most recent document, MRMIB is targeting PPO model coverage plans allowing for provisions to match the new federal PPACA guideline (no annual or lifetime caps, lower deductibles (under $1500) and so on).
According the the MRMIB, target date for the risk pool to be operating is September, 2010.
According to information provide by Pricewaterhouse Coopers (PwC) to the MRMIB, enrollment in the new risk pool could be approximately 25,000 California residents.
For comparison, MRMIP (California's Major Risk Insurance Plan) enrolls a total enrollment of about 7,100.
The risk pool funding will be a combination of premium from subscribers and federal dollars. No state monies will be used to fund the California federal risk pool.
More information as soon as I get it. Remember, the two primary conditions a person must meet to participate in the federal risk pool are:
1. Uninsured for six months or longer and unable to obtain private, group or public health insurance
2. Must have a health condition determined by the pool as a qualifying condition (these have not been published yet)
California MRMIP Enrollment Waiting List
Recently I posted that MRMIP (California's State Major Risk Program) had eliminated the waiting list for enrollments. Apparently they have filled all of the open enrollment slots and now have a 1-month waiting list to enroll.
For information on MRMIP including plans, benefits and rates, visit my California Health Plans page.
MRMIP Clears Backlog (No Enrollment Waiting Period)
The California MRMIP (Major Risk Medical Insurance Program) has apparently received some additional funding and has cleared the backlog of applications.
As of today (5/19/10) there is no waiting list for MRMIP enrollments.
I am working on obtaining specific information regarding the federal temporary risk pool which is scheduled to open July 1. In the meantime eligible uninsurables may enroll in the MRMIP without an enrollment waiting period.
More MRMIP information here
MRMIP Will Not Be Used For Risk Pool
Today the CA Governor announced that California will not use the MRMIP program as the temporary high risk pool for uninsurable California residents.
Instead, MRMIP will continue to operate alongside the federal risk program to be established by HHS in the next few months.
Stay tuned for more details on the temporary risk pool and how to enroll. Remember, the federal risk pool is a temporary program to 2014 to help cover those who cannot obtain private health insurance and have been without insurance coverage for six months or longer.
MRMIP is a California state risk program for CA residents who are unable to obtain private health insurance. The current waiting list for MRMIP enrollment is 3-4 months from application submission.
Temporary Risk Pool (California)
Just a quick update on one of the provisions of healthcare reform that goes into effect in September--the temporary risk pools for the uninsurable who have 6 months or more uninsured (and are uninsurable).
Each state was given the option to use a federal risk pool (HHS) or, if that state has its own risk pool, to use the state program and receive federal $$ for it ($5 Billion earmarked for these temporary risk pools).
While I assume California will likely us the California MRMIP program for eligible California residents, a decision has still not been made by the MRMIB (Major Risk Medical Insurance Board) in Sacramento.
I called them this week for an update and was told that they are still meeting about it and working through the myriad of implications for using MRMIP.
I will provide updates as they become available and as we get closer to the initial changes under the new Healthcare Reform law.
For more information on California's MRMIP health insurance risk program (and other state programs), visit my CalHealth page.