August 2, 2011

GOV. MALLOY: LOWER COST FOR MOST ENROLLEES IN PRE-EXISTING CONDITION INSURANCE PLAN

(HARTFORD, CT) - Governor Dannel P. Malloy today welcomed federal approval of a flat $381 monthly premium in the Connecticut Pre-Existing Condition Insurance Plan, a move expected to boost enrollment in the year-old program by slashing premium costs by as much as 57% for older beneficiaries.

"I thank the Centers for Medicare and Medicaid Services for approving my administration's request to make a more affordable premium rate available to many uninsured Connecticut residents," Governor Malloy said. "This program was specifically created as a result of federal health care reform to serve people with serious pre-existing medical conditions. It has been slow getting off the ground, in large part due to premiums that were out of reach for many people, especially older adults."

Governor Malloy said the new, uniform "community rate" premium of $381 will be significantly less expensive for most enrollees aged 50 and older.

"Currently, the top premium amount is $893 for the 65-and-older age group," the Governor said. "While most people in this age group have Medicare and don't need this program, the fact remained that people in the 60-to-64 age range were paying $776. This cost put the program out of reach for many potential enrollees with pre-existing conditions. Beginning September 1, costs will go down for most of the 75 current enrollees, and the lower rate of $381 should go a long way to attract new applicants."

Since its August 2010 launch, the Connecticut Pre-Existing Condition Insurance Plan had based premium rates on age range. Rates for younger people begin at $243 and increase incrementally per ten years of age. For example, the cost is $413 at age 45, $507 at age 50, $628 at age 55, $777 at age 60 and $893 at age 65.

The Department of Social Services, administering agency for the federally-funded program, appealed to federal authorities in late June to collapse the premium schedule into one rate of $381. The state's proposal was approved last Friday by federal officials.

The new rate represents a reduction in premium for about two-thirds of the 75 current members, and is expected to pave the way for enrollment increases in the age groups with the most serious health problems. While current adult enrollees younger than 45 will see premium increases between $23 and $96, depending on age group, the primary market for this program -- older adults -- will benefit significantly.

"On balance, the new $381 premium rate across the board will help attract the main target audience of the pre-existing condition insurance plan," said Social Services Commissioner Roderick L. Bremby. "Middle-aged and older adults with medical conditions usually have the most difficult time finding affordable, good-quality insurance coverage if they're on their own without coverage in the workplace."

Connecticut has another program that serves uninsured adults with pre-existing medical conditions - the Charter Oak Health Plan. New state legislation requires that individuals who are eligible for the Pre-Existing Condition Insurance Plan select that option, rather than Charter Oak. The lower $381 premium will support this requirement by making the Pre-Existing Condition Insurance Plan more accessible. At the same time, the monthly cost for new enrollees in Charter Oak is rising to $446, as a result of medical claim costs and lowered state subsidies.

Unlike Charter Oak, the Pre-Existing Condition Insurance Plan has a firm prohibition on accepting people who have been insured during the past six months, as required by federal law. Applicants who do not meet this requirement can still elect to join Charter Oak, as long as they qualify for one of that program's exceptions to the six-month waiting period, such as financial hardship or loss of other coverage.

"By offering the Pre-Existing Condition Insurance Plan to individuals with qualifying pre-existing conditions, we are also better pursuing the goal of taking full advantage of the $50 million allotment provided by the federal government for Connecticut residents," Commissioner Bremby said.

For more information, visit www.ct.gov/dss and enter search term "pre-existing".

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For Immediate Release: August 2, 2011

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