Application of Antitrust Laws to NAHU Activities
Associations are subject to strict scrutiny under antitrust laws because an association is, by its nature, a group of competitors joined together for a common business purpose. The antitrust laws require companies to make certain decisions by themselves, not in conjunction with competitors. Therefore, associations and their members must proceed with extreme caution in certain areas of activity to insure against violation of the antitrust laws. These activities could lead to revocation of our 501(c)6 exempt status under IRS non-profit tax regulations.
Discussions of the following topics should not take place between members of the same profession or business either in person, by phone or electronically:
1. Do not discuss current or future prices or commissions.
2. Do not discuss what is a fair commission or profit level.
3. Do not discuss price adjustments.
4. Do not discuss credit terms.
5. Do not discuss refusing to deal with or boycotting a corporation.
6. Do not discuss allocating markets.
7. Do not discuss allocating customers.
8. Do not discuss wage rates.
Submitted by -
Arthur L. Herold
Webster, Chamberlain & Bean, LLP
Provided by the National Association of Health Underwriters
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What has NAHU done for you and your clients lately?!
- Janet Trautwein, NAHU CEO, along with others within NAHU’s legislative teams holds seat on committees with the NAIC. They have equal voting power as the insurance commissioners in each state. Janet was involved in an important resolution that the NAIC released, confirming their commitment to the role of insurance agents as an essential part of the health insurance system.
- What does this mean to you?
- The NAIC makes recommendations to HHS as they work on implementation regulations for the Health Care Bill. Having the NAIC commit to and endorse the role of insurance agents is a huge win.
- What does this mean to your clients?
- The NAIC’s goal is to protect consumers from potential unlicensed, untrained and unregulated navigators.
What is MAHU going to do for you and your clients?
- Did you know that the language in the law concerning the exchanges leaves it up to the states to decide where consumers will access their subsidies? MAHU commits to work to ensure consumers in Michigan will continue to work with their licensed agents to navigate the new system and the possibilities for funding. Don’t forget that the subsidies are not only set up for individuals but for small groups looking for access as well!
What has MDAHU done for you and your clients lately?
- Janet Trautwein, CEO of NAHU, spoke to over 200 MDAHU members and their clients about what is going on the front lines of the health care reform bill.
- This year’s Board of Trustees has renewed its commitment to members and pledged to offer interesting and relevant membership programs.
- MDAHU will work to have our voices heard in Lansing and Washington on issues that are important to our members.
The Top Reasons To Join MDAHU
Dan Blakemore MDAHU Board of Trustees, President
- Numbers. We need your name and your number in Washington and Lansing. Legislators respond to numbers. NAHU represents 100,000 insurance professionals, we need more.
- Professional responsibility. You make a living in the distribution of healthcare related products. Join the cause to protect the industry and the clients you serve.
- Positioning. Advertise that you are a member of your professional association. The majority of clients participate in their professional associations. Their insurance agent should participate in his/her professional association as well.
- Education. NAHU sends a daily newswire and weekly legislative updates concerning health care news. NAHU sponsors certification courses and CE. Its website is one of the most comprehensive and up-to-date and available only to members.
- Programming. MDAHU offers compelling programming in the form of monthly meetings, CE opportunities, speaker series for your clients, a golf outing and an annual Expo.
- Funding. We need your money in Washington and in Lansing. A portion of the dues you pay go to funding the effort to preserve the private health insurance market.
- Political Action. The Health Underwriters Political Action Committee (HUPAC) is your opportunity to donate money that is used to support people and causes working to protect our industry.
- Connecting. MDAHU offers the chance to serve on committees or on the board—to make friendships across agencies or companies; to network; to find lifelong friends serving with folks who share a common passion.
- Giving. MDAHU supports local charities, such as Special Days Camp and Rainbow Connection, through volunteer activities and fund raising.
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6/12/10
Dear MAHU members,
On Friday, Pat Pennefather, Cathy Cooper, Gary Reed and I had a meeting with Commissioner Ken Ross and Deputy Commissioner Joan Moiles to discuss the implementation of various aspects of PPACA. We discussed the following areas:
Health Insurance Ombudsman: This is a work in progress that hasn’t had very much movement as of yet due to more pressing issues. We took the time to explain that members of MAHU act as this for our clients everyday and that we would really like to be involved in the development of the position within OFIR
Minimum Loss Ratios: Commissioner Ross indicated that they are still waiting on the development of this data from both HHS and NAIC. We expressed that this is of great concern to MAHU members since this is how we are compensated for providing the service. We told him that the NAHU leadership has been working closely with HHS in the development of what goes into the MLR calculation.
High Risk Pool: We were informed that an RFP is going to be going out next week to interested parties which appear to be the HMO plans and BCBSM. The time allowed for response has been shortened due to the time requirements for the establishment of the HRP. They hope to have chosen a partner or partners by Mid July. The HRP will abide by the PPACA guidelines with an estimated Open Enrollment to begin on September 1st with coverage being effective on October 1st. More details about the plans and particulars will be coming out once the RFP process is completed. When we asked about agent commissions for the HRP plans, we were told that the carrier or carriers that offer plans will use the same distribution channels they use now for Individual products. Some of the criteria for enrollment in the HRP is:
· Person must have been without insurance for 6 months
· They must be a legal resident of Michigan
· They must have a pre-existing condition
· They don’t have to have been denied in the standard market
· There will be only one product design offered
When asked about how the funding would be done once the $140m of Federal money ran out, the Commissioner stated that they HRP would be limited to a certain number of slots within geographic areas and then would be closed down. We are concerned about whether this is allowed within the rules of PPACA. I’ll be sending an email up to NAHU to get some further clarifications on that issue.
Web Portal: The State and the Insurance carriers have the responsibility to provide HHS with the information that will be loaded into the Web Portal that is supposed to be up and running by July 1st. They have no idea if this will actually be functional by the July 1st PPACA deadline.
Exchanges: We have provided OFIR with information regarding the Utah and Massachusetts Exchanges as OFIR is currently awaiting additional guidance and regulations from the NAIC and OFIR. This is really in the infancy stages as far as they are concerned.
MAHU will continue to keep you updated as progress continues on these topics.
Respectfully,
Michael A. Embry, RHU
Legislative Chairperson
Michigan Association of Health Underwriters
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On May 5, 2010, Janet Olszewski, Director - Michigan Department Community Health, testified before the Senate Health Policy Committee. Her testimony was on the federal healthcare reform and its impact on Michigan. You can view her presentation by clicking the icon to the right.
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| Michigan Grass Roots Initiative Program MIGRIP |
Why Should I Support MIGRIP?
MIGRIP monies support our legislative lobbying effort in
Lansing.
With over 140 pieces of legislation tracked during the last
legislative session, it is vital to our organization to have a
presence and voice in Lansing full time. With term limits, it
is virtually impossible for a volunteer organization to meet
and have working relationships with the members of the
State’s Legislature.
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MIGRIP AUTO ENROLL FORM |
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