Pulling the Curtain Back on Health Insurers

The health insurance fog is about to lift.

S.200, VPIRG’s signature health reform initiative this year, sailed through the Senate and got even stronger in the House.  The bill would force health insurance companies to pull the curtain back on claims denial, profit, and influence.  Information is power and S.200 is key to ensuring that Vermonters are being treated fairly and that our premiums dollars are spent on care, not to pad the bottom line of the health insurance industry.

During the final days of the 2012 legislative session, we’re asking Senators to vote on the side of justice and support the current version of S.200, as amended by the House.  If you haven’t already, take a moment to ask your Senators to support the strengthened S.200.

Although 5 other states collect some data on claims denial, Vermont’s approach to transparency and consumer protection will be the strongest in the country.  Here’s what it does…

Health insurance companies that cover at least 5,000 Vermonters will have to report the following information to the state each year:
•    The total of number of claims they receive;
•    The total number of claims they deny, by category;
•    The names, positions, and salaries of all corporate officers and board members during the preceding year;
•    The bonuses and compensatory benefits of all corporate officers and board members during the preceding year;
•    The health insurer’s marketing and advertising expenses during the preceding year;
•    The health insurer’s federal and Vermont-specific lobbying expenses during the preceding year;
•    The amount and recipient of each political contribution made by the health insurer during the preceding year;
•    The amount and recipient of dues paid during the preceding year by the health insurer to trade groups that engage in lobbying efforts or that make political contributions;
•    The health insurer’s legal expenses related to claims or service denials during the preceding year; and
•    The amount and recipient of charitable contributions made by the health insurer during the preceding year.

All of this information must be submitted to the state in a plain-language memo and posted online for every Vermonter to see. This will be especially helpful once Vermont’s health benefit exchange is up and running in 2014. Thousands of individuals and small businesses will access to affordable coverage and more choice when it comes to their insurance company.

Information is power and that’s the last thing your insurance company wants you to have.  But you and I know that being sick is stressful enough without having to spend hours on the phone with your insurance company or avoiding bill collectors, for care that should have been covered.  It’s time to follow the money and shed some much-needed light on the coverage decisions that can mean life or death, security or poverty, for thousands of Vermonters.