Ge TCV ieoH Hed m aC SL iT INU (eTcea A State-by-State Analysis Twenty-Sixth Edition, 2012/2013Comprehensive Health Insurance For High-Risk Individuals A State-by-State Analysis Twenty-Sixth Edition 2012/2013 2012 NASCHIP Chair Information contained herein has been furnished ‘Amie Goldman, CEO to NASCHIP and is accurate to the best of Health Insurance Risk-Sharing Plan Authority NASCHIP's knowiedge. State-specific information 1751 W. Broadway, P.O. Box 8961 was provided by the pool in each state, Madison, Wi 53708 (800) 828-4777 itis not practical to provide all details about the benefits, costs and services of each program. The 2013 NASCHIP Chair reader is encouraged to contact inlvidual state Michael Keough, Executive Director programs for specific details, policies and benefit North Carolina Health Insurance Risk Pool statements. NASCHIP assumes no responsibilty 3739 National Drive, Suite 228 for inaccuracies beyond our control Raleigh, NC27612 (919) 783-5766 published by NASCHIP National Association of State Comprehensive Health Insurance Plans wun naschip.org ©2012 NASCHIP Allrights reserved. No pat of this book may be reproduced in any form or by any means without prior written permission from the publisher.Louisiana 4 Louisiana Health Plan(LHP) stg www.lahealthplan.org 5 OPERATIONAL DATA : 2009 2010 aoi1 FEOF Pool Particpants At Year End 1,322 1,638 1728] Teerage HOF Pool Frcs ee 1235 i502 | 188 Total Premiums Collected an $7,187,839 S7A4i.287 $9,044,622 Total Assessments Required $4304 737 | $4256.82 —| — $705 667 Total Other Revenue ‘$4,424,885 ‘$3,536,586 $3,404,243, Total Poder Reinbusonst ass For Medel rd Gains | Stoaiss3e | ~stasstes | Siarrtare | Total Oe Cots (PA Fes, Fool Ani, Ec) 31,622,965 | $1845351 | $2058 018 2011 PLAN MEMBERSHIP PREMIUMS (Mca Yxr En) Frequency Of Changes: Ancually Established B Independent acu High Risk Poo 587 “ Cet HIPAA Pan: 141 1) patiog Methodology: Descriptio: 5 top individual carriers $1,000 Deductible: aay || referent eerie ak $2,000 Deductibe: 553 1] ise sa caeuation Yes $3,500 Deductible: 209 i Ponders $5,000 Deductible 676 (cll terra Nea nM ‘Max SRR % Mlowed By State Law: 200% Range OF SAR % Currently In Place: 110% to 200% Avg SRR% for Non-Medicare Plans: 155% Premiums Vary By: Age, Gender, Smoking Status, Geography, HIPAA Eligibility. LHP maintains two separate pools (High isk Pool and HIPAA Pool) and rates are based on eligibility ineach poo. But Not By: Income, Experienc/Heath, Length of Tine in Poo, ————— Frior Continuous Coverage aoa Freniums May Be Ftd By Member, Direct Fanily Member, Government Agencies: Medea sms ie ike fe siege || Auemorsy, embers Employer, Special interest Groups Aa $40 se soot |] | ate Tales Cn Be Found At: woahealtnplanorg Hospi Utilization 1,000 ‘patient Ads: an Penge 1 |] Low-income premium suasipies Pen etepON Subsidy Offered in 2012? No Members average 2.8 scripts per ce oe month hile brand drugs represent Ha Tyce, | Average | Maram | 975057 7 yaave man Income for | Members Funding in only 29% ofthe count of rset, Soy | subadeca | O8cunt | Disc | Fendi Design? they ae 78% ofthe cost of x aes a 2 spt | Comments: None Motes: PUPH = Per Meniber Per Month /1000 = Per 1000 Members Per Year © 2012 NASCHIP Al rights reserved OMPREHENSIVE HEALTH INSURANCE FOR HIGH-RISK INDIVIDUALS LOUSIANA = 57South Carolina : South Carolina Health Insurance Pool winw.doi.se. gov OPERATIONAL DATA #7 Of ool Paripans Ri Year fg ——————__ fea ——— Total Premiums Coated or Total Other Revenue an ie 7a Proverbs ass Far Mee Cas Total Other Costs (TPA Fees, P Pool Adin, te) = 2011 PLAN MEMBERSHIP PREMIUMS (tla or Aieaueney OF anges, ne Pera bythe Director of Insurance and 31 days totice 80/80 Network Option: | teed: Independent actuary 80/60 Network Option: gg bere eaves ioe 1305 | | Aetna Meticdotoay Medicare Supplement 45 | | Bier Descrnien [me SPR takes into account the rates ofthe five lest insurers oftng individual overage Se Use SR Caleta Yes Weighted Or Sinple Average: Site ‘Mat HR $5 Mowed By State Law: 200% ange OF SRR % Gurenty in Place: 200% ‘Aig SIRS or Non Medicare Pans: 200% Premiums Vay by: Ase, Gender Those eligible due to premiums wich 258 oe 2 POO premiums mut pays adtonl condition exclusions are waived. [ 2023 utiizatin But Not By Smoking Status, Geography, income, HIPAA Eligibility, 2011 Utilization Eiarlenee/iath, Length of Time in Poo ie Coverage se tinuous Medical $023 fe $142 |) Premiums May 8 Paid By Member, Direct Family Member, Government Agencies, Adnan $62 ‘An insurable Interest Total: S112 | Bue not by. NembersEmplayer, Special interest Groups Hospitel Utieation / 1,000 ‘ate Tables Can Be Found dt: wane doe gov ‘npatent Adis: 254 eater Gos toe || towancome PREMIUM SUBSIDIES Outpatient Services: 4068 1b Ofeed ncae oa Haximuin | — % of | Members avera rig an rugs represent only 38% of the count ‘Of x scripts, tee fer Se Design? they ate 86% ofthe cost of bsoy | Subsiiced sarps, ae Cnment: Nove Notes: PUPM = Per Member Per Month (1000 = Fer 1000 Menibers Por Year L © 2012 NASCHIP Al rights reserved (COMPREHENSIVE HEALTH INSURANCE Fon HIGH-RISK INDIVIDUALS SOUTH CAROLINA g3