Health Insurance in Ohio – Many Challenges Ahead

According to a report prepared for the Ohio Department of Health Insurance, over 60 percent of Ohio’s residents get their health insurance through their employers. However, Ohio Lt. Gov. Mary Taylor says there could be a lot of confusion ahead for businesses as well as individuals when shopping for health insurance in Ohio. Talyor, who is also Director of the Ohio Department of Insurance, says that policies could also become expensive, with higher premiums and new fees required to run a state health care exchange. Ohio is one of the 19 states that are still studying options to set up an exchange which, according to law, is expected to be up and running by January 2014.

Health Insurance Exchanges – Issues Involved

A health care exchange is expected to be a place where lower-income residents and small employers can shop for Ohio health insurance and compare a variety of subsidized health plans. It is also expected to give the state better control over the commercial health insurance market, lower risk selection, and promote state health reform programs. Policy makers also say exchanges will allow better coordination of benefits and eligibility rules across health coverage programs such as Medicaid and child health insurance plans available through them.

However, setting up an Ohio health insurance exchange and ensuring that it achieves intended goals will not be easy. Many issues would need to be resolved.

• Ohio, like other states, is struggling to balance its budget, and a health exchange is an expensive proposition. Ohio Lt. Gov. Mary Taylor released a report last year which showed that the operating cost of a state-run from would amount to $19 million to $34 million per year.

• Employers would face some confusion with list-bill rating. As employees can choose from several health plans offered by a single carrier, the group’s premiums would need to change from composite rating to list-bill rating. Under composite rating, premiums are set on a group basis, and the rates would be the same for all individuals and families. But under list bill rating, premiums would be different for each individual and family that enrolls in coverage. This complexity could affect the ability of the exchange to attract employers.

• Another issue that employers would face is how they will deal with multiple insurers, ensure proper verifications on employees, and protect themselves from penalties. This will involve many administrative complexities and additional expenses for employers and affect their purchase of coverage via the exchange. In the present system, all this is handled through one health insurance Ohio company or through a broker.

• Another important concern relates to getting the health exchange up and running by 2014 and self-sustaining by 2015. According to Taylor, this may mean that insurers or policy buyers have to pay new fees.

Health Insurance in Ohio - Important Role for Brokers

If Ohio does indeed set up a health insurance exchange, the role of the broker must be clearly defined. Individuals and business owners rely on brokers to get quotes from various carriers, study their options, and purchase quality health insurance OH. Therefore an experienced, licensed Ohio health insurance broker would have a major role in helping to resolve many of these challenges, especially in helping an exchange to attract and retain customers.