CAP to Close Its Doors
The provision of the Affordable Care Act which awarded federal funds to the CNMI Dept. of Commerce for the Consumer Assistance Program, no longer applies to the CNMI as decided last week by the administration of CMS/HHS. Due to the loss of federal funding, the Consumer Assistance Program will close its doors on Wednesday, July 23, 2014. CAP staff regret to have to leave our duties as health care consumer advocates, but we value the experience and knowledge gained from setting up the program and providing education to the community. Please forward any complaints or concerns regarding your health care coverage to the CNMI Insurance Commissioner, Sixto K. Igisomar, at (670) 664-3077 or 664-3064.
New Development in the ACA’s Applicability to the Territories
The Dept. of Health and Human Services has reconsidered the definition of state as it pertains to the territories. Read the letter to our own Secretary Igisomar here. More news to come.
Improving our Health without Doctors and Pills
The Washington Post issues a special report on Health Beyond Health Care. Read the report here.
Health: A patriotic duty
Watch Acting Surgeon General Rear Adm. Boris D. Lushniak explain why simple healthy acts, such as walking and cooking at home, ought to be viewed as patriotic duties.
“The economy doesn’t do anything without a healthy workforce. It doesn’t do anything without healthy people.” -General Rear Adm. Lushniak
The White House Issues Report on Missed Opportunities with Medicaid Expansion
Today, the Council of Economic Advisers released a report, Missed Opportunities: The Consequences of State Decisions Not to Expand Medicaid, which details the effects of state decisions regarding Medicaid expansion on access to care, financial security, overall health and well-being of residents, and state economies.
Medicaid Website is Up and Running
Check out the new CNMI Medicaid Website for information about the CNMI State Medicaid Agency.
State of Enrollment Conference 2014
We’re back from an amazing gathering of health care advocates, health insurance marketplace assisters and state and federal government employees. See what we learned here.
Check out our new FAQs!
We made our FAQs easier for you to navigate. Check them out at the “Frequently Asked Questions” page and submit your own question for us to include!
What to Do When Charged For Preventive Care Services
Under the Affordable Care Act, certain in-network preventive care must be covered by your health insurance plan at no additional cost to you. This includes “well-woman” visits, breast-feeding support and supplies, contraceptive methods, vaccinations, diabetes and blood pressure screening and many other services. Health insurance providers are still getting used to these new rules so it’s important that you know your rights under your health insurance plan. If you have health insurance and have been charged for preventive services such as birth control pills, an annual exam, or pap smear, contact the CAP for help!
For more information, check out this awesome toolkit from the National Women’s Law Center for complaint letter templates and FAQs about women’s preventive care coverage rights.
Want to Help Lower Health Care Costs for Everyone?
Eat Well, Stay Healthy, Avoid Diseases
Eating well and staying active can keep you from getting sick. Preventing disease by investing in a healthy body is more cost-effective for you and your family. Fortunately for us in the CNMI, fresh healthy food grows year-round in our own backyards. Think healthy food is too expensive or time-consuming? Think again. Check out the new Healthy Eating on a Budget resources from the US Department of Agriculture.
Internship Opportunities at the CAP
NAIC Writes to President Obama Re: Territories
The National Association of Insurance Commissioners (NAIC) sent a letter to President Obama following up on his request that HHS Secretary Sebelius and CMS Administrator Tavenner investigate what steps the federal government might take to help alleviate the health care reform problems facing the territories. The President’s request to HHS was made during the the NAIC meeting with President Obama on April 17, 2014. Read the full letter here.
2012 Hawaii Medical Services Association. Learn more at healthcareplainandsimple.com
Pacific Directors of Health Meet to Discuss the Non-Communicable Disease Crisis
Non-communicable diseases (NCDs) such as diabetes, heart disease and cancer are responsible for more than 70% of all deaths in the Pacific region. Often, these diseases are preventable and treatable, and NCDs impose a huge financial burden on Pacific Islands’ governments. Health directors recently met in Fiji to discuss this epidemic. Read more about it here.
Insurance Commissioner Extends Transition to Affordable Care Act Compliance
On April 23, 2014, CNMI Insurance Commissioner, Sixto K. Igisomar issued this notice to carriers extending the transition period to ACA compliance for eligible health insurance policies until 2016. This means that some plans in the CNMI will not have to comply with ALL of the Affordable Care Act market reforms and consumer protections until renewal after October 1, 2016. For more information about how this may affect you, call 664-3005 or email the CAP at advocacyoffice@commerce.gov.mp.
Get Ready Resources from NAIC
Help avoid costly surprises by educating yourself early about insurance. The National Association of Insurance Commissioners offer helpful resources for making important life choices such as buying a house, buying a car, or getting married.
Check out their “Get Ready Resources” here.
Updated Factsheet Available from the Asian and Pacific Island American Health Forum (APIAHF)
The APIAHF has released an Implementation of the ACA and the U.S. Pacific Territories_Factsheet outlining the application of the ACA to the territories, appropriately subtitled “Opportunities and Challenges).
2014 Health Action Conference Materials Available
Want to know more about what CNMI CAP employees learned this January? Videos and presentation material are available here. Be sure to check out Vice President Joe Biden’s speech!
Excellent Website for Easy-to-Understand information
Click on the link below to go to the Hawaii Medical Services Association website explaining health care. Keep in mind that any reference to a “marketplace”, “exchange” or requirement for individuals to have coverage does not apply in the CNMI.
http://www.healthcareplainandsimple.com/
How do I get health insurance? How do I sign up for “obamacare”?
Unfortunately, there really is no such thing as “obamacare insurance”. The new federal health care laws, otherwise known as “Obamacare”, don’t create any new types of insurance. If you ever hear “obamacare insurance” on the news, they are talking about the redesigned health insurance plans developed by existing insurance companies which are made to comply with the new laws. These new laws require insurance companies to offer certain essential benefits and mandate other kinds of consumer protections like no pre-existing condition exclusions and offering coverage to anyone regardless of health status. In the mainland US, residents can shop for and buy these “redesigned” insurance plans on a website called the “health insurance marketplace” or “exchange”.
We don’t have this type of website in the CNMI. The reasons for this are complex, and if you want to know more about this, contact us (670) 664-3005 or advocacyoffice@commerce.gov.mp.
Now, to answer the question, “how do I get health insurance?”
Currently, the only options to get new health insurance coverage in the CNMI is either through an employer who already has a contract with an insurance company or through Medicaid if you qualify for eligibility.
CNMI insurance companies that used to offer “individual coverage”, meaning insurance you don’t get through an employer, are not currently selling new plans (as of 3/14/14). Reasons for this are complex as well, so please contact us for details on this. The Consumer Assistance Program is working with both insurance companies and our insurance regulators to get new insurance plans available as soon as possible.
Thoughts? Concerns? Complaints? Contact us!
Mobile clinic in Kagman this Saturday
The Commonwealth Healthcare Corp. will be exhibiting the Mobile Health Clinic on Saturday, March 8, 2014, at the Kagman Community Center from 8am to 11:30am.
In our efforts to bring healthcare services to individuals residing in the northern villages, these services will be provided on this day for attendees. Services will include skin testing, flu vaccination, blood pressure and glucose checks, and well child checks. Other services available, however, will be limited, including Pap smear, pelvic and breast exams. Doctors will be present and education about health will be available. The community is encouraged to take advantage of the services provided.
An ounce of prevention is worth a pound of cure.
For more information contact CHCC Public Health at (670) 234-8950 or (670) 236-8703. (PR)
CNMI PL 18-34 established the CNMI Rate Review Process
This amendment to the CNMI Insurance Code was signed by Governor Inos on Valentine’s Day and gives greater power to the Insurance Commissioner to promulgate rules and regulations mandated by the Patient Protection and Affordable Care Act. It also creates a process to regulate health insurance rates to ensure they are not excessive, inadequate or unfairly discriminatory. Though the rate review office can’t make insurance companies charge lower rates, it does make sure that rate increases are appropriate according to provider cost and claims experience, among other factors. See the link for an overview of the process.
Attention Tinian and Rota!
The CAP and the Small Business Development Center have teamed up!
Join us to learn about the healthcare system and how the Affordable Care Act could affect you and your small business. Don’t have a business? No problem, ALL are welcome.
Please contact the CAP if you would like to schedule a healthcare training for your organization.
Agreement with Aetna Reached For Govt. Employee Health Plan
See the memo that was issued on Feb. 7: OA-14-M053 2014 Health Insurance Coverage
Important news about your 2014 health plan-Prettied (1)
Requests for Comment Issued
Secretary Igisomar issued the following requests for comment to help inform upcoming policy decisions. All comments should be received by February 19th, 2014.
Request for Comment- Employer Responsibility
Request for Comment-strategies for limiting adverse selection
Free health screening outreach
Sunday, February 9, 2014
The Quarterly Community Health and Wellness Program, a non-government organization, is hosting its second free health screening at the Minatchom Atdao in front of Marianas High School this Sunday, Feb. 9, 2014.
The health screening, which will be held from 7:30am to 12pm, will provide free services such as breast and Pap smear exam, hypertension and diabetes screening, eye check-ups from Hardt Eye Clinic, and influenza vaccines for children ages 2 to 3 years old.
Hot soup will also be served.
The services are made possible by St. Paul Episcopal Church, Hardt Eye Clinic, Marianas Advocates for Humanitarian Affairs Ltd. or Mahal, DEKADA movement, Division of Public Health’s Mobile Clinic, Northern Marianas College’s College of Nursing, community organizations and other various volunteers, individuals and professionals. (Jayson Camacho)
Resources available from Health Action Conference
Click here to access the materials used in the workshops the CAP staff attended. The CAP learned some valuable lessons at the conference including:
- Some of the issues the CNMI is facing with the implementation of the ACA are shared by other states (especially “red” states) or other states have already dealt with these problems. We can look to other states for strategies to limit adverse selection, lower premiums and expand Medicaid.
- Many of the barriers to health found in our community are similar to those of the American Latino community. This means we don’t have to “re-invent the wheel” when we develop ways to overcome these barriers.
- There are hundreds of hard-working and motivated people dedicated to improving the US healthcare system and we were able to make some valuable contacts with organizations who are eager to help us in the CNMI
The office of the CNMI Consumer Assistance Program will be closed from Jan. 22-27 to attend the Health Action 2014 Conference.
If you need assistance during this time, please email advocacyoffice@commerce.gov.mp or call (670) 483-0104 and leave a message. We will check messages daily. Click here for a link to the conference agenda. If you’re interested in hearing about what we learned at the conference, feel free to contact us and we will be happy to fill you in!
ACA Symposium
Held December 16, 2013 Multi Purpose Center, Susupe
At this symposium, insurance industry stakeholders, lawmakers, government officials, and regulators were invited to discuss the major insurance market reforms and how these reforms will change insurance plans and policies in the CNMI. Additionally, this event addressed the impacts of the ACA on the CNMI insurance market.
The goal for this symposium was to ensure that all CNMI elected officials, regulators and health care stakeholders are on the same page regarding the ACA in the CNMI and are well-informed of the ACA market reforms and impacts. See below for the presentations which were given at the symposium.
ACA Symposium Consumer Assistance Program Presentation
Commonwealth Healthcare Corporation Presentation
Calvo’s Presentation on Healthcare_Reform CNMI
New Administrative Notices Issued to Health Insurance Carriers
Two new administrative notices were issued today from the CNMI Department of Insurance to insurance carriers. These notices address rate and form filing requirements and the maintenance of “grandfathered” plans.
Adminstrative Notice 2013-07 Rate and Form Filing
Administrative Notice 2013-06 Grandfathered plans
What you should know about grandfathered plans as a health insurance consumer…
Grandfathered plans or policies are those that have been around since March 23, 2010 and have not changed significantly in premium rates, benefits or cost-sharing requirements. It is important to know if your plan or policy is grandfathered as these kinds of plans do not need to comply with many new requirements of the federal health care reform.
Your insurance company must notify you if your plan or policy is grandfathered.
Administrative Notice Issued to Health Insurance Carriers
A new administrative notice was issued to carriers today, providing clarity on the new transition option they are permitted to offer to current enrollees.
Guidance issued on the “Transitional Policy” announced by the Obama administration
The following is an excerpt from a factsheet issued by the White House regarding this new option to protect consumers from getting their policy cancelled.
“…HHS is using its administrative authority to:
- Allow insurers to renew their current policies for current enrollees without adopting the 2014 market rule changes. This will give consumers in the individual and small group markets the choice of staying in their plan or joining a new Marketplace plan next year. HHS will consider the impact of this transitional policy in assessing whether to extend it beyond 2014.
- Require insurers offering such renewals to ensure consumers are informed about their options. Specifically, insurers offering these renewals must inform all consumers who either already have or will receive cancellation letters about the protections their renewed plan will not include and how they can learn about the new options available to them through the Marketplaces which will offer better protections and possible financial assistance.
- To protect against the potential impacts this change will have on premiums, HHS will adjust the temporary risk corridor program which is designed to stabilize premiums as changes are implemented. [Please note that the Marketplace coverage mentioned above is not available in the CNMI.]
Whether an individual can keep their current plan will also depend on their insurance company and State insurance commissioner – but today’s action means that it will no longer be implementation of the law that is forcing them to buy a new plan. Turnover is high in the individual market, with 50 to 67 percent of enrollees staying for a year or less. This means that the number of people in these bare-bones policies will decrease over time. As such, this action provides a smoother transition in a market that’s generally used as a bridge by most consumers.”
Read the FAQS on this transitional policy here.
This letter from Director Gary Cohen provides further guidance on this policy and includes the standard notices that insurance carriers must send to enrollees if this type of renewal will be offered.
Please note that insurance carriers cannot alter these notices in any way and must send a notice to you if they already did, or plan to, cancel your plan or policy. Please contact the CAP at (670) 664-3005 or advocacyoffice@commerce.gov.mp if you have questions on this new option, or if you need help understanding a notice you have received from your insurance company.
Centers for Medicare and Medicaid Services (CMS) announces compliance leniency for health plan/policy renewals through 2014. See the letter to insurance commissioners.
On November 14th, CMS sent a letter to insurance commissioners informing them of the decision to allow plans and policies in the individual and small group market to be renewed in 2014, even if they are not ACA-compliant. This decision was made to help smooth out the transition into ACA compliance and to ensure consumers are not cancelled from their plan or policy with no other affordable options to choose from. Insurance companies may only offer a renewal option on these non-compliant plans/policies and must fully inform the consumer of the coverage differences between a compliant and non-compliant policy. Insurance companies are prohibited from offering these older, non-compliant plans to new customers in 2014.
What this means for you, the consumer…
This means that if you like the individual or small-group market plan or policy you have had in effect since October 1st, 2013, you can still renew it in 2014, even if it is not compliant with all the ACA market reforms. In fact, you can renew it up to October 1st of 2014 for year-long coverage. So, if you renew your plan next year on October 1st, 2014, you can have the same plan until October 1st, 2015.
If you have questions on this new transitional policy, please contact the CAP office at (670) 664-3005 or advocacyoffice@commerce.gov.mp
Letters sent from Governor Inos to Dept. of Health and Human Services Secretary, Kathleen Sebelius
On October 21st and 23rd respectively, CNMI Governor Eloy S. Inos sent letters to Secretary Sebelius informing her that the CNMI will not participate in a health insurance exchange and to request a delay in market reform implementation. See links to letters below.
1. Letter to Kathleen Sebelius re-Health insurance exchange 10-21–1
2. Letter to Kathleen Sebelius re- ACA Market reform & EHB Extensi-1
National Association of Insurance Commissioners (NAIC) White Paper, “Implementation of the Affordable Care Act in the U.S. Territories”
This paper was sent to Secretary of HHS, Kathleen Sebelius and other federal government officials on October, 16 2013. The “white paper” explains the possibly adverse effects of the ACA on the insurance industries of the US territories. NAIC Territories Letter Final US Territories Paper Final
Administrative Notices Sent from the Insurance Commissioner to Insurance Carriers
October 11th, 2013
Adminstrative Notice 2013-03 (Implementation)
Sent from the CNMI Insurance Commissioner to insurance carriers to formally notify them that they must comply with the applicable provisions of the Affordable Care Act.
Adminstrative Notice 2013-04 (early renewal)
Sent from the CNMI Insurance Commissioner to insurance carriers to advise them how to conduct early renewal offers to enrollees.
Join us to learn more about the Affordable Care Act at one of the following October town hall meetings.
All are welcome!
Tinian
Wednesday, October 9
7:00-8:30pm at Natibu Park
Rota (NEW SCHEDULE)
Thursday, October 17 Monday, October 28
6:00-7:30pm at the Mayor’s Conference Room (SongSong)
Tuesday, October 29
5:00pm at the Rota Youth Center (Sinapalo)
Saipan
Friday, October 25
6:00-7:30pm at the American Memorial Park Theater
Scammers Take Advantage of Health Care Reform Confusion
State Insurance Regulators Warn Consumers to Be On Alert
Since the Affordable Care Act (ACA) was signed into law in March 2010, unscrupulous scammers have been creating ways to take advantage of consumers’ uncertainty surrounding the law. Posing as insurance agents or representatives of the federal government, these scam artists try to sell fraudulent policies or obtain sensitive information like Social Security and bank account numbers. The National Association of Insurance Commissioners (NAIC) and state insurance regulators are warning consumers about common red flags and providing tips on how to avoid being the victim of a scam.
Health Insurance Marketplaces
One of the largest components of the ACA is the creation of new health insurance marketplaces, or exchanges. These online portals ask consumers to enter information about themselves and select the level of coverage they desire to receive a list of plans they can purchase. Each state had the option of running its own exchange, partnering with the federal government or having the federal government run its exchange entirely.
Be aware that the CNMI does NOT have an exchange or insurance marketplace at all. If someone tries to contact you regarding a “CNMI exchange” please report this to the CNMI CAP (Consumer Assistance Program) office.
Open enrollment in the new marketplaces begins October 1 in the mainland U.S. However, bogus websites that purport to be part of the exchanges have been appearing online for more than a year. Do not enter any personal or financial information into a website that says you can purchase a policy from an exchange in the U.S.
New “Obamacare” Insurance or Medicare Cards
Another common ploy involves unsolicited calls from scammers who claim to have your new “Obamacare” insurance card – they just need to get some information before they can send it to you. The caller then asks for credit card numbers, bank account information or your Social Security number. A variation of this trick specifically targets seniors on Medicare; the caller claims that in order for them to get their new Medicare card and continue receiving their benefits, they must verify their bank account and routing numbers. Some callers ask for their Medicare numbers, which are identical to Social Security numbers.
You are not required to obtain a new insurance or Medicare card under the ACA. Also, anyone who is a legitimate representative of the federal government will already have your personal and financial information and should not ask you to provide it.
Don’t Be Misled
Here are some other important “red flags” to watch out for:
- The salesperson says the premium offer is only good for a limited time.
Enrollment in the exchanges will be open from Oct. 1 to March 31, and rates for plans in the exchanges will have been approved for the entire enrollment period. Be skeptical of someone who is trying to pressure you into buying a policy because the rate is only good for a short time. Remember: if the offer sounds too good to be true, it probably is.
- The salesperson says you could go to jail for not having health insurance.
Starting in 2014, all Americans will be required to have health insurance, however, the CNMI is exempt from this provision. CNMI residents face no penalty for being uninsured.
- You receive an unsolicited phone call or email from someone trying to sell insurance.
The federal government and state insurance departments will not be contacting individual consumers to sell them insurance. Do not give any sensitive information to anyone who claims to be with the federal government, your state insurance department or a navigator for your state’s exchange.
Protect Yourself
The best way to protect yourself from insurance fraud is to research the agent and company you’re considering. Always STOP before writing a check, signing a contract or giving out personal information. CALL the CNMI CAP office (785-8890) and CONFIRM that the agent and company are licensed to write insurance in your state.
More Information
The above information is from an alert issued by the National Association of Insurance Commissioners (NAIC). For more information on the NAIC’s activity on healthcare reform, visit the Healthcare Reform Special Section. You can find more information on the ACA on the HHS website.
CNMI Consumer Assistance Program 
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