| Formal Name: | Comprehensive Health Insurance Pool |
| Contact Person: | Martin Swanson, Health Policy Administrator, Nebraska Department of Insurance 941 O Street, Suite 400 PO Box 82089 Lincoln, NE 68501 (402) 471-4648 martin.swanson@nebraska.gov; Michelle Dunlap, Aetna ATTN: CHIP PO BOX 541210 Omaha, NE 68154 (402) 995-7155 |
| Purpose: | It is the purpose and intent of the Legislature to provide access to health insurance coverage at an affordable premium to all residents of Nebraska, including those individuals denied coverage due to a preexisting medical condition or whose policy includes a restrictive rider limiting coverage for such a condition. The purpose of the Comprehensive Health Insurance Pool Act is to provide a mechanism to ensure the availability of health insurance coverage to individuals unable to purchase such coverage for a preexisting medical condition either on an individual or group basis directly from an insurer. It is the intent of the Legislature that adequate levels of health insurance coverage be made available to residents of Nebraska who are otherwise considered uninsurable or who are underinsured due to a medical condition creating a high risk. It is the intent of the Comprehensive Health Insurance Pool Act to provide affordable insurance for individuals with such medical conditions by making such health insurance coverage available. Because of the Affordable Care Act (ACA), the only remaining individuals in the Comprehensive Health Insurance Pool (CHIP) are those on Medicare under the age of 65 due to disability and unable to obtain a Medicare Advantage plan due to a lack of availability in that county. |
| How Many Affectable: | As of July 2016, 8 individuals remain in CHIP. |
| How Many Served: | As of July 2016, 8 individuals remain in CHIP. |
| Year Created: | 1985 |
| Year Active: | 1985 |
| Sunset Date: | NA |
| Number Of Members: | 7 |
| Who Appoints: | Director of Insurance |
| Legislative Approval: | No |
| Qualifications Of Members: | Pursuant to section 44-4216, the board shall be selected by the director and shall be composed of four representatives of domestic insurers, one representative of health agencies which are involved in advocating for individuals with special health care needs, one representative of individuals eligible for pool coverage, and one representative of the general public. The representative of health agencies shall not be a member of the board of directors, an officer, or an employee of an insurer.The representative of individuals eligible for pool coverage (I) shall not be a member of the board of directors, an officer, or an employee of an insurer and (II) shall be an individual who is eligible for pool coverage or who would be eligible for pool coverage if he or she were not otherwise eligible for other health coverage, or the spouse, parent, adult child, or guardian of such individual. The representative of the general public (I) shall not be a member of the board of directors, an officer, or an employee of an insurer or of a health agency which is involved in advocating for individuals with special health care needs and (II) shall not be an individual who is qualified for selection as the representative of individuals eligible for pool coverage as provided in subdivision (2)(b)(ii)(B) of section 44-4216. |
| Per Diem: | None unless traveling on business then paid for costs as approved for by the Board. |
| Expense Reimbursement: | None unless traveling on business. The Department of Insurance will reimburse a DOI employee for traveling to CHIP Board meetings if outside of Lincoln. |
| Term Length: | The statutes do not specifically limit the term of length of a board member, rather membership is based upon eligibility. That said, the appointments are made for a four year term based on the plan of operation. |
| Terms Rotate or Expire At Once: | Terms Rotate |
| Support Staff: | Administration is done at Aetna Insurance. A portion of some work is preformed at the Department of Insurance |
| Shared or Separate: | Shared |
| FY 13-14 Budget: | CY 12: Premium Income $22,356,253 Claims Incurred $30,021,784 Operating Costs $1,339,121 Distributive Fund Transfer $8,999,645 |
| FY 14-15 Budget: | CY 13: Premium Income $30,341,379 Claims incurred: $46,470,578 Operating Costs: $1,611,827 Distributive Fund Transfers: $17,938,255 |
| FY 15-16 Budget: | CY 14: Premium Income $443,887 Claims incurred: $363,181 Operating Costs: $17,734 Distributive Fund Transfer ($63,743) |
| Other Funding Sources: | In the past, grants have been available. Those grants have expired. |
| Spending Authority: | Yes, the Board is empowered by section 44-4220 to transact the business of health insurance that would include the ability to contract with providers, actuaries, and any other entity that an insurance company would contract with for health care insurance |