Discount Medical Plan Hearing Presentation

1
Discount Medical Plan Hearing Presentation

• FAHP thanks the Office of Insurance Regulation
  and Commissioner Kevin McCarty for scheduling
  this important hearing on Discount Medical Plan
  Organizations.
• Thank you for inviting me to present FAHPs input
  today.

2
Discount Medical Plan Hearing Presentation

• FAHP represents 22 health plans both PPOs and
  HMOs in the State of Florida.
• Our plans insure over 8 million citizens in the
  State of Florida. Some of our health plans offer
  regulated discount medical plans in conjunction
  with or supplemental to health insurance
  coverage.
• Our plans contract with over 40,000 health care
  providers including physicians, hospitals,
  laboratories, and other health care providers.

3
Discount Medical Plan Hearing Presentation

• The DMPO law and regulation adopted by the OIR
  have served an important purpose in regulating a
  market that was previously unregulated and
  subject to abuse. The prior DMPO marketplace
  needed regulation as certain market entrants
  misrepresented their offerings and took advantage
  of some Florida residents.
• Most important are regulations that protect
  consumer from being mislead to believe that DMPOs
  offer the same protections as health insurance.
• Due to OIRs implementation of Part II, Chapter
  636 Florida Statutes, we have significantly
  reduced the number of questions and complaints
  that our plans have received since the
  regulations took effect in 2005.

4
Discount Medical Plan Hearing Presentation

• The types of DMPO complaints our plans were made
  aware of included
• Confusion over whether or not individuals had
  purchased insurance
• Complaints about providers refusing to honor
  discounts
• Lower discounts on services than were promised by
  the plan
• High pressure sales techniques
• Recently, we have become aware of plans that have
  unbundled their discount cards in order to avoid
  compliance with actuarial certification
  regulations that protect consumers and weed out
  the illegitimate discount cards from those that
  offer value.

5
Discount Medical Plan Hearing Presentation

• FAHP is aware that regulated DMPOs that
• Have set fee schedules that are published
• Have published and accessible provider networks
• Offer real discounts in relation to the price of
  product
• Are an important market segment, and coupled with
  health insurance, have an important role in a
  consumer directed portfolio of products that
  include high deductible health plans, health
  savings accounts and HRAs, and transparency of
  health information.

6
Discount Medical Plan Hearing Presentation

• FAHP supports current regulations and additional
  regulations that will not serve as a hindrance to
  innovation and specialized discount plans that
  offer real value to the consumer.
• FAHP supports efforts to educate consumers of the
  purpose and value offered by discount cards so
  that they can be aware of how these DMPOS fit
  into a portfolio of products that include
  insurance and tax favored health accounts.
• FAHP supports both regulation and education that
  protects and informs consumers from being mislead
  to believe that DMPOs are health insurance or
  offer the same protections as health insurance.
• FAHP supports full transparency of health
  information including full disclosure of DMPO
  networks and discounts to the consumer.
• Thank you again for scheduling this meeting and
  inviting me to speak today.