(The Center Square) – Health insurance companies in Pennsylvania could be required to provide more robust data to a specific group of small businesses based on a recently passed law. However, insurance industry officials say the change, if adopted, could lead to a number of ramifications.
State Rep. Dave Zimmerman, R-East Earl, is the primary sponsor of House Bill 947, a law that would require insurers practicing in the state to provide claims information to employers with 51 to 99 people on a group plan.
“We are at a time when everything seems to be about transparency,” Zimmerman said at a recent House Insurance Committee meeting to discuss the proposal. “I really see this as a transparency law. It seems that this type of company has really struggled with COVID for at least the last year. “
Several speakers at the recent House Committee meeting said HB 947 is positive, especially as small business owners try to get out of the economic challenges posed by a pandemic.
Dave Zartman, President of Zartman Construction, said current insurance regulations under state law have challenged his business as he tries to negotiate tariffs annually – a task he thinks is all the more difficult without aggregated data to guide his search for underpin competitive tariffs.
In February, Zartman said the company’s share of insurance premium costs had increased 52 percent. A total of 96 employees and family members are on his company plan.
“We are denied access to our data,” said Zartman. “This data is important for two reasons: first, we can judge whether an interest rate adjustment is realistic and appropriate; Second, it provides other insurance companies with accurate information for competitive quotes. “
Zartman’s situation is frustrating due to a provision in state law, he said. If there were 100 or more people on his employee insurance, the insurers would have to provide the data he was looking for.
Thomas Purcell, legislative chairman of the Central Pennsylvania Association of Health Underwriters, shared similar concerns with state law and called for changes to make data available to employers who insured 51 to 99 people.
“It’s a very profitable market for insurance carriers,” Purcell said. “We simply demand more transparency and a level playing field.”
Several health insurance industry experts also spoke about the legislation, saying it could lead to unintended consequences.
Kim Kockler, vice president of government affairs for Independence Blue Cross, said Pennsylvania employers with 51 to 99 policyholders have an advantage because they are part of a pool.
“It gives them protection – protection from the bad years of entitlement,” said Kockler. “One year can blow you out of the water in this group size.”
Mike Yantis, vice president of state government affairs at Highmark, said privacy is the overarching reason that insurance companies often fail to provide historical loss data when requested.
Yantis said concerns about the Health Insurance Portability and Accountability Act, a federal law that restricts the sharing of medical information, come into play when working with such a small group of policyholders.
“We take our concerns about HIPAA very seriously,” he said.
The committee, which met on June 9 to discuss HB 947, made no official recommendations and no next steps in the legislative process were announced.
But on the surface, committee chair Tina Pickett, R-Bradford, said she was open to the legislation.
“In my past, I’ve been a former business owner and I support the concept of providing a small business owner with relevant information to help them make informed decisions,” said Pickett.
The bill was sent back to the House Rules Committee after unanimous approval in the House Insurance Committee on Thursday.