After all this talk about health care prices going up and government plans to take away health care responsibilities from employers, it is a different theme to hear then about a state government that is going to give money to employers for health care expenses.
That is right. The state of Oklahoma recently passed a law that would make health care more affordable for everyone perhaps, according to my sources. The bill was just signed into law by the governor of Oklahoma, Gov. Brad Henry, a Democrat. There are actually two laws that the governor signed, both of which have to do with the costs of health care and ways to decrease it.
The first new law in Oklahoma is called SB 424, and it makes it so that it is easier for poorer residents of the state to get health care benefits from the state. Instead of having to be below the 185 percent of poverty line level in the state, no citizens can be less than 300 percent of the poverty line in terms of salary and get the state health care assistance when it comes to buying health care for their children.
The law is called the All Kids Act, and it provides a cheaper health care plan for parents through a private insurance plan. The overall costs of the plan will be about $4200 per year for a child. The parents, however, will only pay about one quarter of that, while the state and the federal government will pick up the rest of the tab. The new law is expected to give this new benefit to an additional 45,000 children about in the state. It will cost overall about $8.2 million over the course of the next three years, and will be paid through another form of tobacco tax on cigarettes and such.
It is the next law that all of us employers might be more interested in. This second law that Gov. Brad Henry signed directly affects how many employers in the state will do health care benefits going forward. What the new law will do is provide some form of subsidies for employers that give health care benefits to their employees. As with the previous health care related reform law, this employer helping bill will also get paid for by a tobacco tax in the state.
Some of the money will also come through a settlement that the state of Oklahoma got as part of the big tobacco settlements of the 1990s. in 1998 to be exact, the state of Oklahoma got about half of a million dollars from Big Tobacco for all of the cancer patients that could have come about in the state because of cigarettes and other tobacco products.
Not much more details on the new health care plan in Oklahoma were released by my source, as to whether or not all employers in the state will get this new health care insurance benefit subsidy, or whether only smaller employers in the state will get it and larger employers will need to keep paying for health care benefits on their own. And it is not entirely clear how much of a subsidy this new law will provide to whatever employers it is covering. But one thing is sure—it is a new form of health care reform that we have not really seen in other states, so in that regard, the state of Oklahoma is relatively innovative and should have a close eye on it, even if you are not an Oklahoma employer. The Sooner State could be providing an interesting example for the rest of us to follow.
If you’re an employer with a health plan that includes mental health treatment, did you know that the caps on benefit amounts for that care cannot be lower than the limits on other medical care? A recent ruling has extended the Mental Health Parity Act (MHPA) until December 31, 2007.
The act will have a strong effect on Oklahoma employee benefit plans, and nationwide applies to 150 million employees. The ruling extending the law comes down from the Employee Benefits Security Administration (EBSA).
The federal agency covers most businesses in the U.S. Its job is to guarantee that group insurance plans abide by laws controlling pensions and health plans. The MHPA became law in 1996, and since that time has been subject to five amendments extending it past its September 31, 2001 “sunset clause,” or expiration date.
Group health plans are not allowed to put lower limits on mental health coverage than they do for medical procedures, including surgery. Before passage of the original law, your company’s coverage plan could legally have a $250,000 limit on medical care benefits but a $15,000 limit on mental health treatments. Now the two must be equal – plans with the $250,000 medical limit must have the same $250,000 benefit limit on health care. Annual caps on benefits are covered also, with mental health coverage equal to the lifetime or annual ceiling on medical or surgical procedures.
What’s included under the category of mental health treatments? Stays in rehabilitation facilities, or “rehabs” for treatment of alcohol or drug dependency are covered, as are visits to mental health professionals – licensed therapists, psychiatrists, and psychologists. Also included are stays in the mental health section of a medical hospital, or in mental hospitals themselves, for illnesses like schizophrenia, post-traumatic stress disorder, and depression.
There is nothing in the law requiring you as an employer to have a mental health component in your group health insurance program. It requires instead that, if you already have mental health coverage, its benefit limits must be equal to those of your plan’s medical or surgical treatment coverage.