Adam,

I?m confused. In your exchange with Dallas Woodhouse at the Pulse blog on a high risk health insurance pool, you claim that ?All companies are paying a share since all benefit from the pool.?

Third-party administrators and reinsurers pay the fee, but this still doesn?t include employee health coverage offered by every employer. The state health plan is specifically included in the high-risk pool bill because the state self-insures. Why is this necessary, since the state contracts with BCBSNC? Also, if every company is already included in the pool, why was there a debate about shifting the assessment onto hospitals instead of insurers?

Finally, the feasibility study by Milliman [PDF] states:


In our opinion, due to ERISA regulations, the State may have difficulty collecting assessments on self-funded lives that are not covered under stop-loss insurance. Mississippi is the only state to our knowledge that applies this definition of covered lives [which included ?Any other nongovernmental entity providing a health benefit plan subject to State insurance regulation?].


The current bill does not have that broad language, so it sounds like it still excludes at least a few self-insured companies.

Can you help me understand the differences?

Thank, Joe