vahu newsvahu news inside: get connected with other vahu members: visit us online message from the...

Washington (Cnn) - Washington is braced for the expected release early this week of a Congressional Budget Office analysis set to reveal the cost and projected reach – and limits – of coverage for the GOP’s bill to repeal and replace major parts of Obamacare.

If, as expected, the report warns that millions of people currently insured thanks to the Affordable Care Act could lose that coverage, it could rock the debate over the bill -- already facing problems due to Republican infighting.

Democrats will be certain to frame attacks on the GOP bill, the American Health Care Act, as taking away health care from those who have it, putting the onus on Republicans to argue why people should back their efforts.

That could prove a millstone for Republican lawmakers -- including in blue-collar areas that President Donald Trump won on a promise to provide better and more affordable coverage than Obamacare -- in the run-up to midterm elections in 2018.

The White House and congressional Republicans argue that the CBO projections won’t tell the full story, that people who have insurance under Obamacare are hammered by high deductibles and rising premiums and need relief. In such cases, they might have care, but it is hardly affordable, they say.

“The one thing I’m certain will happen is CBO will say, ‘Well, gosh, not as many people will get coverage.’ You know why? Because this isn’t a government mandate,’” House Speaker Paul Ryan said on CBS’s “Face the Nation” Sunday.

Pressed to say how many people might lose coverage, Ryan said, “It’s up to people.”

“We’re not going to make an American do what they don’t want to do,” Ryan said. “You get it if you want it.”

Therefore, it’s not surprising leading GOP figures are downplaying the CBO’s assessment of their plan, which does away with the Obamacare mandate that everyone must have health insurance, offers tax breaks based mainly on age instead of income and cost of coverage, and rolls back an expansion of Medicaid.

“Nobody will be worse off financially in the process that we’re going through,”

Health and Human Services Secretary Tom Price said on NBC’s “Meet the Press” Sunday.

“What we want to do is to put in place a system that will allow for folks to select the coverage that they want,” Price said -- an answer Breitbart News labeled a possible “Lie of the Year.”

VAHU News

InsIde:

get connected with other VahU members:

Visit Us Onlinewww.vahu.org

Message from the President 2

Chapter Updates 3

Spotlight: Brenda Cutting 4

Membership Update 5

Annual Convention 6

HUPAC Update 8

Legislative Update 9

Notes from NAHU 10

VIrgInIA AssOcIAtIOnOf HeAltH UnderwrIters

Email: [email protected]: www.vahu.org

Linkedin.com/in/virginia-ahu

Facebook.com/virginiaasociationofhealthunderwriters/

#Virginia_AHU

March 2017

Congress Braces for Congressional Budget Office report on gOP Proposal

A lot is Happening at VAHU. Be a Part of it!

Visit www.vahu.org and click on “Join now”

2 VahU News • www.vahu.org/ Produced by Jaffe Communications VahU News • www.vahu.org/ 3Produced by Jaffe Communications2 VahU News • www.vahu.org/

The Virginia Association of Health Underwriters mission is to educate, influence, and inspire insurance professionals and legislators to lead the development of the future health insurance environment for the citizens of the Commonwealth of Virginia.Virginia Association

of Health Underwriters

Produced by Jaffe Communications

Message from the President

Would you like more exposure to the members of VAHU? This is your opportunity to have your company’s ad here, in the monthly VAHU News as a sponsor.

Please email: [email protected] for ad pricing.

Your ad could be here!

As we can finally see a glimpse of spring, I am here to further lift your spirits and remind you that the annual VAHU conference is just around the corner!

Ditch your desk, pack a bag and head down to the Sheraton Virginia Beach for our signature event on May 22-23. We expect to have more exhibitors than ever, more sponsors than ever and more attendees than ever. Basically, more fun than ever. Bring the family for a weekend away – we have limited availability at our negotiated room rate for the weekend, so book fast.

This year you don’t want to miss our new and improved schedule. It’s the year of the broker and we are ready!

The action all starts on Monday morning at 9 a.m. with Topgolf. Join us for some fun to kick off this exciting event. Back at the Sheraton, we will begin with CE classes from 2 – 4 p.m. followed by a cocktail party in the exhibit hall from 4 – 5:30 p.m.

Then, get ready for an exciting evening aboard the Spirit of Norfolk. We will depart at 5:30 p.m. for a networking boat cruise with our sponsors and exhibitors. This is sure to be an evening you will not soon forget.

Roll out of bed the next morning and start Tuesday with a general session, lunch and even more exhibitor time than ever before. From 2 – 4 p.m. we will have more CE’s and then end it with a presentation by Frank Beamer, the legendary football coach for Virginia Tech.

A special thanks to heather Kochanowicz, our conference chair, who is working diligently to provide an amazing experience for our members this year. Heather has been outstanding and we are truly appreciative of all her work.

As President, it was an incredible source of pride to see more than 30 VAHU members attend Capitol Conference last month in

Washington, after more than 200 people attended our CE Day in August. We are sure an active bunch.

VAHU – with membership now surpassing more than 330 professionals – is served by the dedicated volunteers on our hard-working committees. They fuel new members and widespread interests, establish strong communications both internally and externally and create an even stronger voice for us in the halls of Richmond and Washington, D.C.

I hope to continue to promote member engagement through strong recruiting and the hosting of member “give back” events. The state is heavily supporting our local chapters by providing recruitment funds as discussed by our membership chair, Josh Viles, in the membership update on page 5 of this newsletter.

With the outcome of this year’s presidential election, there are so many questions and concerns about potential changes to the health care industry. I am proud to say that our team at VAHU has stayed on top of it all and has become “the source.”

Our Communications Committee has also been superb, under Chairman Cameron DeBord and Jessica Bagby, ensuring VAHU continually has a strong voice in the media, and producing informative publications like this issue of The VAHU News.

Meanwhile, our Legislative Management Team, headed by Chris Renkar and amy Mutter, has been incredible, having routine conversations with key state leaders. It is because of the work of the LMT that VAHU was able to have such a strong showing at Capitol Conference.

VAHU is stronger than ever. It is the only organization that aims to protect jobs in our industry. Please consider getting more involved. I look forward to seeing you in Virginia Beach in May and talking about ways in which we can soar to even greater heights by working together.

I wish you a productive and wonderful spring.

By Lindsey Waters

2 VahU News • www.vahu.org/ Produced by Jaffe Communications VahU News • www.vahu.org/ 3Produced by Jaffe Communications

chapter Updates VIR G IN IA V A H U

SW• VAHU

P• VAHU

NVAHH

E• VAHU

C• VAHU

Northern Chapter

By Kim Molthen

The Northern Chapter hosted a successful Lunch & Learn on February 27 featuring Roger Bayne. Roger spoke on the ramifications of Repeal and Replace. The event proved to be both informative and well-attended.

save the date for the nVahU annual topgolf Charity Event! Thursday, April 6, 2017, 3 6 p.m. at Topgolf in Ashburn, VA. Registration is now open and sponsorship opportunities are available! The cost is $50 for members; $65 for non-members.

Proceeds to benefit the Sweet Julia Grace Foundation. The foundation focuses on meeting the non-medical needs of children who are chronically or seriously ill, have special needs or in the midst of a medical crisis. Please visit www.northernvahu.org for

registration and details.

Southwest Chapter

By amy Mutter

The Southwest Chapter will host a membership luncheon on March 15, 2017 at the Hunting Hills Country Club in Roanoke from 11:30 a.m. – 2 p.m. Roger Bayne, President of Benefit Indemnity, will present: Implications of Repeal and Replace

(2 CE Virginia). There is no charge for members. First time attendees will receive 50% off non-member pricing, paying just $10 to attend. Non-members pay just $20. We expect record attendance so sign-up today!

Prior to the luncheon, the current Board will meet to discuss strategic planning and chapter business. Members are encouraged to attend both events. Members interested in all levels of involvement on the SWVAHU leadership team are particularly encouraged to attend the morning strategic planning session which will commence at 9:30 a.m.

Our Annual Golf Outing has also been scheduled for Thursday, May 25th at the beautiful Hunting Hills Country Club.

Please visit www.vahu.org/swvahu to register for our events.

Central Chapter

By Matt irvine

The Central Chapter board meeting will take place on March 24 and the next membership meeting will be held on April 11 at 12 p.m. The meeting will feature the live streaming of NAHU CEO, Janet trautwein, presenting: Live from NAHU! 100

Days In – The Outlook for Health Reform. The session will review the actions proposed and underway by the Trump Administration including the status of the “repeal and replace” effort as well as the legislative priorities being pursued by NAHU.

Please visit www.vahu.org/cvahu to register.

PVAHU Chapter

By Lori West-Carter

The Piedmont Chapter, in conjunction with the Southern Chapter, will host a membership luncheon on March 15, 2017 at the Hunting Hills Country Club in Roanoke from 11:30 a.m. – 2 p.m. Roger Bayne, President of Benefit Indemnity,

will present: Implications of Repeal and Replace (2 CE Virginia). There is no charge for members. First time attendees will receive 50% off non-member pricing, paying just $10 to attend. Non-members pay just $20.

The Piedmont Chapter April meeting will take place on April 11 at 12 p.m. The meeting will feature the live streaming of NAHU CEO, Janet trautwein, presenting: Live from NAHU! 100 Days In – The Outlook for Health Reform.

EVAHU Chapter

By anya simpson

The Eastern Chapter April meeting will take place on April 11 at 11:30 a.m. at the Holiday Inn Virginia Beach-Norfolk Conference Center, and the price will be $15 for members, $25 for non-members. Lunch is included. The meeting will feature

the live streaming of NAHU CEO, Janet trautwein, presenting: Live from NAHU! 100 Days In – The Outlook for Health Reform.

HUPAc is working for you.Where do you spend $10 a month?

How about spending it on your career?Email us today at [email protected] or visit www.vahu.org to make a donation

4 VahU News • www.vahu.org/




spotlight Brenda Cutting

Our March spotlight features Brenda Cutting. Brenda was raised in Virginia Beach, and, as a native to the area, she has witnessed the city change and grow dramatically throughout the years.

Brenda’s entry into the industry extends all the way back to her high school days. While taking a business course, her teacher referred her for a part time job with a special risk life insurance agency. The part time job morphed into a full time career upon graduation.

In 2001, Brenda joined the financial services division of CPA firm, Goodman Financial, where she championed their Employee Benefits department. Soon after, the company restructured and the financial services division broke off to begin Sterling Benefits in 2003. Brenda is happy to report that she, along with her three original colleagues, continue to grow the company with locations in Virginia Beach and Midlothian.

Brenda has always made it a priority to participate in professional organizations. “Personally, VAHU has been invaluable in providing opportunities for continued education, keeping current on legislation, providing an outlet to network with carriers and a platform for peers to bounce ideas around,” Brenda said. “More than anything, being involved with VAHU builds upon my credibility for my clients and, at the end of the day,

it’s all about doing the best for our clients.”

Brenda has held numerous positions on both the chapter and state level. As a member of the Eastern chapter, she has served as Secretary, Professional Development Chair and is currently the Chapter Treasurer. At the state level, she has held the positions of Conference Chair, Secretary and is currently the State Treasurer.

To young brokers out there, Brenda highlights the importance of building your credibility and having NAHU on your resume. “When you are a NAHU member, other NAHU members are particularly willing to help elevate and educate you. There is room for all of us to succeed in this industry by supporting each other,” she said. “Insight comes from years of tackling client problems. Nothing is cookie cutter. It is our responsibility to introduce good ideas and resources to our clients so they can make informed decisions.”

So what’s something that we don’t know about Brenda?

Brenda was married and licensed in the same year over 33 years ago. She took some time off to obtain her Bachelor’s Degree. Brenda attended a VAHU meeting to re-immerse herself in the industry and network. It was at this meeting where she learned of the open, unpublicized position with Goodman Financial. The rest, as they say, is VAHU history.

NAHU’s Leading Producer Round Table (LPRT) encourages excellence among its members by recognizing their sales achievement.

LPRT members demonstrate exceptional professional knowledge and outstanding client service. NAHU formed the Leading Producer Round Table in 1942 to recognize the successful underwriters of accident and health insurance. Today, NAHU and the LPRT Committee are committed to making LPRT the premier program for top health, disability long-term care and worksite marketing insurance producers, carrier representatives, carrier management and general agency/agency managers.

To qualify for LPRT, you must be actively employed in the health insurance industry and make positive contributions in your professional endeavors.

For more information, visit www.nahu.org.

lPrt

Congratulations to 2016 LPRT Qualifiers:

golden Eagle LevelGary Cox

soaring Eagle LevelAlan Jones

Lawrence O’BrienLindsey Waters

Eagle Level Arthur AccardoTimothy HicksHarrel Parker

Christopher Renkar

VahU News • www.vahu.org/ 5




Membership report

The membership team proudly welcomes four new members to VAHU since January 1. That’s four of our industry peers who will now be taking advantage of everything VAHU has to offer. In January and February

we welcomed:

The membership team in every chapter has been hard at work reaching out to new members and retaining the members we have. Once an individual joins, the membership team gets them involved in the many great events that are held each month both on the local and state levels. The team has stayed even closer than ever to our current members to ensure they take full advantage of VAHU’s increasingly strong value proposition.

If you’re a new member, challenge us to help you experience the value and get everything from your membership that you expect. Take every ounce of value from our organization that you can – and don’t be surprised when our members, vendors, sponsors and other friends extend a helping hand as you focus on growing your business.

soMEthing nEW!!!: To all VAHU members, please let us know which of your friends or colleagues might benefit from VAHU membership! Simply complete our “Refer a Friend” form (located on the VAHU Home page) with the names of three friends

or colleagues who might be interested in a VAHU membership. We will follow up with them and tell them about the amazing benefits of membership.

Everyone who submits a completed form will be entered into a drawing to win a $100 VISA gift card! (You’ll see these forms at your local chapter meetings as well as on the website.)

Invite your friends to experience all the benefits a VAHU membership has to offer. Members must not have been a member in the previous 12 months to qualify for the drawing.

And as if that wasn’t enough, first time attendees to the Annual VAHU convention, May 22-23 in Virginia Beach, can get full access for just $70 – this is a savings of 50 percent off. Non-member first time attendees can attend for just $90, and we urge you to take advantage of this incredible value.

Please keep in mind that your investment in VAHU is just a little more than $1 a day. Your monthly credit card commitment is offset by your attendance at the many meetings, CE courses and events that we provide all year statewide. Every registration fee is slanted so that members pay substantially less for meetings than non-members.

Bottom line? Without you, there would be no VAHU. And without VAHU, the role of the health insurance broker in Virginia is at-risk.

Thank you for working together to ensure that our industry is healthy and vibrant.

By Josh Viles

dale Marianellis

MaryParker

Jeanniesuarez

davidware

Recommend three people you think would be interested in VAHU - we’ll do the rest! Fill out the referral form and get entered into a drawing to win a $100 gift card to be awarded at the VAHU Annual Conference.*

Recruit a friend: if 2 friends join VAHU, you get $50 off State Conference. If 4 people join, you get $100 off State Conference!

*Your friend must not have been a member of VAHU in the last 12 months to qualify for these promotions.

Questions? ContactMembership Chair Josh Vilesat [email protected]

Thank you to our generous sponsors who have already committed their support:

Bronze Sponsors

Sheraton Virginia Beach Oceanfront Hotel

May 22-23, 2017The Year of The Broker

Gold Sponsors

EDGE

Copper SponsorSilver Sponsor

The Year of The Broker

Sheraton Virginia Beach oceanfront hotel

Special Convention rate of $145/nightCall 757-425-9000 and mention the VAHU Annual Conference

Bring the family for a weekend getaway! Guests may join us for Top Golf on Monday morning and guests 21 and over may join us on the boat cruise Monday night.

Hotel rates valid through April 20.

Special gueSt Speaker: footBall coach frank Beamer of Virginia tech!

early Bird regiStration deadline: april 24 Full Conference (includes Cruise) & Top Golf$140 Member$180 Non-MemberRates go up to $170/$210 after April 24 First-Timer pricing: $70/$90Conference Only (includes Cruise)$100 Member$140 Non-MemberRates go up to $130/$170 after April 24 First-Timer pricing: $50/$70Top Golf Only$60 Member$100 Non-MemberRates go up to $90/$130 after April 24

Join us on the Spirit of Norfolk!Monday night, May 22 at 5:30 pm

Bring a 21+ guest for just $45!Includes Dinner, Open Bar, Networking,

Dancing, Games and Much more!

8 VahU News • www.vahu.org/ Produced by Jaffe Communications VahU News • www.vahu.org/ 9Produced by Jaffe Communications8 VahU News • www.vahu.org/




HUPAc Update

VAHU is a strong supporter of NAHU’s Health Underwriter’s Political Action Committee (HUPAC). The purpose of HUPAC is to raise funds from NAHU members for the purpose of supporting the political campaigns of candidates who believe in private sector solutions for the health and financial security of all Americans.

Thank you to those who are supporting our industry on a monthly basis. Your support is critical in ensuring our seat at the table in Washington.

“NAHU continues to make strategic use of funds and we would like to thank our donors, chapters and non-members for their continued support,” HUPAC Chair Chris Renkar said.

But to accomplish the aggressive legislative goals of the organization, it is critical to generate more donors, with a consistent stream of revenue to build up the fund. “We need to double or even triple what we have in reserves in order to get a seat at the very valuable table where we need to be,” he said.

Capitol Club Double Diamond William Kite Charles Webb

Capitol Club Diamond Janet Trautwein

Capitol Club Gold Kimberley Molthen Susan Rash Krys Reid

Congressional Michael Burns Lori Carter Jeffrey Ford Sue Johnson Amy Mutter Robert Stutts

Senatorial Arthur Accardo

365 Club Jill Age

Lynn Atkinson Mark Brooks Brenda Cutting John Hinck Alan Jones Jon Katz Cathryn Lovich Lisa Martin Kenneth Penn Brooks Powell John Scott Anya Simpson

Supporter Carlo Abbruzzo

Dorothy Allen J.L. Allison Mary Applewhite Deborah Beaghler

Lisa Buswell Linda Butz Grayce Carter Beverly Cherry Gary Cox Dennie Denison Lila Dickerson Robin Haas Joseph Hannah Debi Harding Thomas Heckard Timothy Hicks Donald Hoffman Robert Kelly Kimberly King Steven Korahaes Vicki Lucas Joseph Moss Elisa Nelson Keith Nelson

John Norce Barbara Penn Christopher Renkar Jason Reynolds Kim Rodgers Barbara Rogers David Stinnett Deborah Stocks Susan Taylor Todd Taylor Stanley Ullman Joshua Viles Lindsey Waters

One-time Contributor Laura Clark

Dawn Frappollo Michele Herbert Cathy King James McHenry

thank you hUPaC Contributors!


The GOP plan has been releasedThe GOP plan has finally been released

(all 123 pages of it) – a far cry from the 2,200+ page PPACA bill that has developed well over 33,000 pages of regulation. At time of submission of this article, the Congressional Budget Office (CBO) has not provided a score on it. What will occur now is an interesting road-map. The bill will go to the House Ways and Means and House Energy and Commerce committees for mark up and final drafting prior to being received by the CBO for a score on the overall financial impact. We expect the CBO to receive this by the Friday March 10. Thankfully we can find nothing in this draft pertaining to the elimination of the employer exclusion. If you recall, Speaker Ryan had wanted to “cap” if not eliminate all together. This was a last-minute change to satisfy conservative lawmakers, businesses and unions. As this bill is in the framework of reconciliation, keep in mind there are only 51 Senate votes required to pass.

2017 Legislative Season RecapThe Legislative management team would like to acknowledge

all the members of VAHU who participated in Day on the Hill and Capitol Conference. We had record turnouts for both events and for this we thank you!

Day on the Hill, Richmond, VirginiaThe Legislative management team reviewed, eliminated,

watched, spoke out about on close to 100 varied bills during the 2017 Virginia General Assembly session. There were a few “repeal and replace” bills that we watched, as we decided it would be better to be safe than sorry – in that we need to have some things in place, should repeal and replace be fulfilled with the Federal administration for January 2018. Kathy Byron, HB2411 was passed in House and Senate, but has not been endorsed by the Governor at this time. Byron’s bill simply rolls back Pre-ACA revisions to provide more uniformity if the ACA is effectively rolled back by the Federal authorities.

Beyond Byron’s bill, the VAHU General Assembly Top 3 are listed below.

“Across stAte LiNes” BiLL (VirgiNiA HB 2233): VAHU voiced strong opposition to this bill along with IIAV and NAIFA. The bill was passed by House, then tabled by Senate after passing in committee. While we as an association applaud the idea of competition, this bill was flawed form the beginning, as it allowed foreign insurers (out of state) to compete in the individual and small group market, but not be bound to the 63 consumer protections that are guaranteed in every health policy sold in the commonwealth. Regional carriers, Virginia agents, and, of course, consumers had potential to be harmed if insurers chose to conduct business based on less regulated states. Additionally, network issues and essential health benefit requirements made it unlikely the outcome of increased competition would be achieved.

HEALTH BENEfIT PLANS OffEREd BY fOREIgN HEALTH INSURERS: Authorizes any foreign health insurer to sell individual or group health benefit plans in the Commonwealth if it is approved to sell such plans in the foreign health insurer’s domiciliary state. The measure establishes requirements applicable to such benefit plans, including provisions for registration, disclosure, marketing, and financial condition. The measure has a delayed effective date of July 1, 2018.

Air trANsPortAtioN Work groUP (VirgiNiA HB 1728): VAHU supported this legislation which easily passed both chambers and was signed by the Governor. We felt this is an important study as there are no real rules concerning pricing for Emergency Air transportation. This dates back to the deregulation of the airline industry back in the 70’s. While we realize this most likely will need to be addressed at the federal level, the ground swell needs to start locally and stakeholders working together to help improve consumer experience is a good start.

dEPARTMENT Of HEALTH; REVIEW RULES gOVERNINg dISPATCH ANd USE Of AIR TRANSPORTATION SERVICES PROVIdERS IN EMERgENCY MEdICAL SITUATIONS: Directs the Department of Health to convene a work group to review the rules governing use of air transportation services, also known as air ambulances, in emergency medical situations and protocols for the dispatch of air transportation services in response to emergency medical situations and to provide recommendations for changes to such rules or protocols. The Department shall report its findings and recommendations to the Governor and the General Assembly by December 1, 2017.

AgeNt commissioN BiLL (VirgiNiA HB 1749): One of the more interesting bills that we were neutral on dealt with commissions from our carrier partners. VAHU recognizes that medical loss ratio requirements are at the heart of commission cuts and energy to correct may be better directed at Federal changes. This bill was ultimately tabled.

ACCIdENT ANd SICkNESS INSURANCE RATE fILINgS; AgENT COMMISSIONS: Requires that premium rate filings for certain health benefit plans include a description of agent commissions and any limitations or exceptions as they relate to the payment of such commissions. The State Corporation Commission is required to review and approve rates for accident and sickness insurance policies offered in certain individual and small group markets.

Capitol Conference, Washington, D.C.The main themes of Capitol Conference included market

stability for the individual market and preserving the employer exclusion. All ears were open and listening as we shared our concerns as constituents with the 115th Congress.

legislative Update

By Amy Mutter & Chris Renkar


coverage. Those who have exceeded 60 days would be subject to a late enrollment penalty and delayed enrollment effective date similar to the penalties for Part B for a five-year period regardless of health status.

Allow states to be eligible for funding for new hybrid high-risk pools. The new pools would not issue coverage but would be available as a reinsurance mechanism to insure risk

above certain levels for high-risk individuals who were enrolled after going longer than 60 days without coverage. Individuals would still be insured by the health insurance carrier of their choice and would not pay a higher premium because of their health status.

Employer-Based Market

Allow the small business tax credit to continue for two years. Since budget reconciliation is likely to include repeal of the small business tax credit, we suggest a delay of

the effective date to at least January 2019 to allow for any businesses currently qualifying from the small business tax credit to receive the benefit through the two-year maximum allotted time period.

Increase flexibility for HSAs. For example, allow contributions equal to the out-of-pocket maximum and a limited number of office visits

to be covered before the deductible each year. Other important changes could also be included but should be considered after other market-stabilization mechanisms are in place.

Preserve the employer exclusion. The employer-based system is highly efficient at providing American workers and their families with

affordable coverage options through group purchasing and its associated economies of scale by spreading risk and avoiding adverse selection. The success of this system is possible because of the preferential tax treatment of employer-sponsored insurance coverage, where employer-paid contributions for an employee’s health insurance are excluded from that employee’s compensation for income and payroll tax purposes. Proposals that would cap the maximum value of the exclusion or eliminate it altogether would be detrimental to the stability of the employer-based market and would negatively affect middle-class Americans who currently benefit from this provision.

Tax and Other Repeals

Repeal the Health Insurance Tax (H.R. 246). Permanently eliminate the national premium tax (HIT) that will add more than $500 annually in costs to a

typical family policy, with the total cost in 2016 of $11.3 billion. Repeal the Excise/Cadillac Tax (S. 58 and H.R. 173)

Permanently repeal the “Cadillac Tax,” which will impose a 40% excise tax on health plans that exceed certain cost thresholds beginning in 2020, following the two-year delay passed in December 2015.

Take action to contact your member of Congress to repeal the Cadillac tax here. Repeal the medical loss ratio requirement.

There should be a full repeal of the medical loss ratio requirement that carriers must abide by. Lifting the restriction that 80% of premium dollars must be spent on medical costs and 20% on administrative costs will provide relief to health insurance carriers struggling to meet the current restrictions, which will result in lowering premium costs and encouraging carriers to remain in the health insurance market. Since health insurance plans have already been approved for 2017, we suggest an effective date of January 1, 2018.

The National Association of Health Underwriters is the leading professional association for health insurance agents, brokers, general agents and consultants. NAHU members work every day with individuals, families and employers of all sizes to help them purchase health insurance coverage and use that coverage in the best possible way. We are a dedicated group of more than 100,000 benefits specialists across the nation who advocate on behalf of our clients – American health insurance consumers. The professional health insurance agent and broker community looks forward to the potential opportunities of working toward healthcare insurance stability. To make the healthcare insurance market more efficient and more responsive to American employers and individual health consumers, we believe some changes need to be made to ensure access, choice and affordability. As the 115th Congress commences, we anticipate that a reconciliation bill will be debated to repeal budget-relevant provisions of the Affordable Care Act and that further legislation will be drafted to replace pieces of the ACA. We would like to respectfully recommend following items: Individual Market

Keep premium tax credits, cost-sharing tax credits and tax credits to territories until an alternative is available. A repeal of the ACA tax credits is likely to be included in a reconciliation bill. We suggest delaying the

effective date to at least January 2019 in order to allow time for a new form of tax credits to be put in place. Allow tax credits to be used outside of the Marketplace if fewer than two choices are offered in a state.

Consumers currently are not able to utilize the tax credit they qualify for because of lack of options in the Exchange. This provision would allow for these consumers to purchase coverage with a tax credit only if there are fewer than two options for coverage in the exchange in their state.

Replace the ACA tax credit with an age-rated flat refundable and advanceable credit. Tax credits should be advanced to carriers as they are today or through tax return at taxpayer’s option. Tax

credit eligibility should be based on age for those not eligible for employer sponsored coverage. The amount of the credit will be based on age in one of five age categories, with a slight weighting toward younger individuals. Coverage can be any state-approved individual-market policy available inside or outside an exchange.

Allow any person to purchase catastrophic category coverage regardless of age or income status. Allow tax credits to apply to this type of coverage. Right now only those who are exempt from the individual

mandate and those under 30 are allowed to purchase and tax credits can’t apply to this category of coverage.

Stabilize the market. Tighten both open enrollment and special enrollment periods to reduce adverse selection and require

documentation relative to special enrollment period eligibility. Reduce the number of special enrollment opportunities to lifestyle changes such as marriage, divorce, birth

or adoption of a child, or loss of coverage not due to policy lapse due to non-payment of premiums. Adjust open enrollment rules.

After an extended new enrollment period, open enrollment can be at any time for those who experience one of the lifestyle changes outlined above as long as they have not gone more than 60 days without

115th Congress: January 2017

WIDESPREADCOVERAGE

175 million Americans get health insurance through their employers.1 People with

employer-sponsored plans are more likely to maintain health

coverage year after year.2

SHARED RISK,STABLE PREMIUMSIt's easy for employees and their families to sign up for coverage through work. So an employer's insurance pool contains people

of all ages and health backgrounds. That spreads risk -- and leads to lower, more stable

premiums.

HARMS MANY WORKERS

Individuals lack employers' buying power, so they won't be

able to purchase the level of benefits they used to have for the

same price. Some in Congress have

proposed new tax deductions to help people pay for insurance. But 45 percent of households have already maxed out their deductions. A new one won't

help them.6

ADVERSE SELECTION,PREMIUMS

Some healthy workers will decline to buy insurance because

it's too expensive. Those who purchase plans despite the

higher price tag will likely be older and sicker.

Insurers will have to pay more to care for this population. To cover their costs, they'll raise premiums further. Gradually, insurance will

become unaffordable for just about everyone.

DONʼT RAIN ON THE EMPLOYER-SPONSORED

COVERAGE PARADE

DONʼT RAIN ON THE EMPLOYER-SPONSORED

COVERAGE PARADE

4https://www.accenture.com/_acnmedia/Accenture/Conversion-Assets/DotCom/Documents/Global/PDF/Dualpub_18/Accenture-Chart-Employer-Beware-Impact.pdf#zoom=505http://kff.org/report-section/ehbs-2015-summary-of-findings/ 6http://www.marketwatch.com/story/45-of-americans-pay-no-federal-income-tax-2016-02-24

1https://www.census.gov/content/dam/Census/library/publications/2015/demo/p60-253.pdf table 1

2http://newsmanager.commpartners.com/nahuw/issues/2016-04-15/index.html3https://www.accenture.com/us-en/insight-employer-beware-workers-demand-health-coverage

HELPS MOST WORKERS

82 percent of workers are satisfied with their

employer-sponsored health insurance.3 Nearly half say they'd quit if their employer stopped offering benefits.4

Some lawmakers want to repeal the employer tax exclusion. That could harm millions of workers

and their families by significantly increasing their taxable income.

The government excludes employer contributions to an employee's health

insurance from the employee's income for tax purposes for both parties. This "employer exclusion" encourages

businesses to offer health insurance and lowers the employee's taxable income.

LESS COVERAGE,LOWER PAY

Businesses would pay nearly $1,000 in new taxes on the average contribution they

currently make toward a family health plan.5 To avoid this

burden, they'll reduce benefits -- or stop offering insurance

altogether. And there's no guarantee that

employers will increase salaries to replace lost benefits.