The General Assembly Action Committee (GAAC) is the state legislative committee for NCAHU. Our goal is to help educate legislators on health care issues in the State of NC that impact the employers we serve and the employees we represent. Our mission is to expand health care access across the state with the explicit mission of preserving the agents role in access to healthcare. The 2021 legislative session convened in January and to prepare the GAAC committee met with many of the members of the House and Senate health committees. The focus of the meetings was to reintroduce the committee and share the role we play in the market. This was a also a time to ask about legislative priorities for the members and to reinforce our organization as an educational resource for them. These meetings were series of successful conversations about the role agents and brokers play in health care access to many of the legislators constituents.
Legislative Meetings: Sen. Joyce Krawiec (R, Dist.31) , Co-Chair Senate Health Committee Sen. Jim Burgin (R-Dist.12), Co-Chair Senate Health Committee Representative Chris Humphrey (R-Dist.12), Chair House Insurance - House Majority Freshman Caucus Whip Sen. Jim Perry (R, Dist. 7), Appropriations on Health & Human Services, Heath Care Sen. Mike Woodard (D, Dist. 22), Health Care, Fiance & Appropriations Rep. Donna White (R, Dist. 26), Appropriations Health & Human Services, Health Rep. Wayne Sasser (R. Dist. 67), Appropriations Health & Human Services, Health, Insurance Rep. Gale Adcock (D. Dist. 41) Appropriations Health & Human Services, Health Nathan Babcock, Senate Staff for Health and Redistricting
Much of the legislative session thus far has been focused on Covid-19 relief and returning children to school. However, we are expecting legislative discussions, if not legislative action around the following important topics: State Medicare Expansion Surprise Billing Pharmacy Benefit Management Certificate of Insurance Scope of Practice Mental Health Early Childhood Health
As an Association we will monitor all of these discussions and any related legislation closely and continue to talk to our legislators about how any of these topics may impact our industry.
To say that Medicare can be confusing is an understatement. As a program that was developed over several generations, it has many layers. A few years ago, CMS decided to re-implement the Medicare "Open Enrollment Period"(OEP), which is not to be mistaken for the Medicare "Annual Enrollment Period."(AEP) Every fall, beginning on October 15th, Medicare recipients are able to switch their Medicare Advantage Plans or their Prescription Drug Plans without any underwriting or other restrictions. This AEP ends on December 7th each year. But...what if someone mistakenly signs up for the wrong plan, or their circumstances change and they need a different plan because of a new doctor or different medications? For many years, the only avenue to make a change was to appeal to CMS and beg for a special enrollment period, or just be stuck in the wrong plan for up to a year. Now that the OEP had been re-installed, it gives Medicare recipients a 90 day window from January 1st till March 31st to make a one-time change if a more appropriate plan is available. During this time, agents are prohibited from marketing to Medicare recipients encouraging them to leave one plan in favor of another plan. (unfortunately there are some agencies and marketing organizations that ignore that rule and inundate Medicare members with solicitations) Again, the intention of this OEP is to correct a potential problem and put the member in a better place. Be careful, however, because if someone is drawn to another plan and it turns out to be a bad choice, the one-time change "free pass" has been used, and it may be very difficult to get out of that new plan until the next AEP, which is nearly a year away. To those of you not familiar with the Medicare rules, this is just a friendly reminder to be weary of Medicare solicitations this time of year, and make absolutely sure that if a plan change is made, it is the right move or you may be stuck in the wrong plan for almost a year.
This year NCPAC is cutting administrative costs by $1,500 over last year by performing most of the regulatory reporting requirements in-house. That means more of your contributions will go to support the campaigns of candidates for the NC State General Assembly. You can contribute as little as $10 per month using your personal credit card. Please consider contributing to the NCPAC. For more information contact me. Teri Gutierrez NCPAC Chair c: 919-880-5151 firstname.lastname@example.org