Gov’t health insurance not in tune with fed laws

Non-compliance of the Government Health and Life Insurance Plan with United States laws has prompted officials of the NMI Retirement Fund to ask for a swift revision of the program.

Fund officials see the need to immediately study plans to revise the existing health and life insurance program of its GHLI Branch because it fails to cover three major aspects.

Retirement Fund Board Chair Vicente Camacho disclosed present policies on health and life insurance will be amended to make it compliant with Health Insurance Portability Act and the American with Disabilities Act.

Once the policies are amended, the program will cover individuals with disabilities, students during school breaks and members of board commissions on off-island travels.

“We are currently reviewing the proposal to bring it to legal compliance of the law,” the board chair explained in an interview.

At present, GHLIB manager Dolores Moore is evaluating the proposal and assessing the covered benefits in hopes to come up with a comprehensive and extensive health plans for everybody.

The revision of the program will address all ADA concerns especially special education student coverage and HIPA regulations and policies, Mr. Camacho added.

The board and GHLIB are currently working on the revisions and amendments to properly evaluate the new study and to closely coordinate all regulations to come up with an effective health and life insurance program.

Mr. Camacho pointed out that the amendments are being carefully looked into despite request of the GHLIB to place the program under the purview of the Office of the Governor.

By doing this, the board chair is optimistic that various problems currently faced by the program will be properly addressed. This include the medical bills incurred by off-island medical referral patients.

Earlier, Ms. Moore urged the Legislature to begin exploring the possibility of appropriately placing GHLI Trust Fund under the Governor’s Office responsibility.

The transfer will enable the program to be more efficient in addressing the issues that have continuously plagued it, the manager explained.

She added GHLITF is in dire need of an updated actuarial study to enable the program to align its fee schedule more accurately. By aligning fee schedule more accurately, it will cover actual medical costs in the CNMI, Guam, Hawaii, and the US Mainland.

The actuarial study will also serve as a benchmark in developing institutional partnership like managed healthcare system with private and public health providers in the Commonwealth.

The possible partnership with private and public health providers will also result in facilitating institutional discounts, timely reconciliation of billing system, and streamlining billing and payment processing.

GHLIP, based on the recent itemized cost breakdown released, is in need of over $4 million funding assistance from the Legislature to settle medical bills on more than 295 off and on island health service providers. (EGA)