Pending regulations put future of GHLIT in doubt

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Uncertainties surrounding the 2010 health care reform law have raised concerns about the sustainability of the AVMA health insurance plan currently covering thousands of Association members and their families.

The AVMA Group Health and Life Insurance Trust is classified under federal and state insurance regulations as a bona fide association health plan. These non–employer-based health plans operate under a different set of rules than non–bona fide association plans and are able to offer a number of benefits because enrollment is limited to association members.

During a session of the AVMA Veterinary Leadership Conference Jan. 6, Libby Wallace, CEO of the AVMA GHLIT, warned that the medical insurance plan "designed by veterinarians for veterinarians and managed by veterinarians" for the past 54 years is in jeopardy of losing its unique status.

Wallace explained that the Patient Protection and Affordable Care Act, signed by President Obama in 2010, is ambiguous on the matter of bona fide association health plans. This has led to concerns that the departments responsible for implementing the reforms—Health and Human Services, Labor, and Treasury—could promulgate regulations that don't recognize association plans such as GHLIT's.

Were that to happen, GHLIT would have to also start offering medical coverage to individuals who are not AVMA members, once the new rules take effect Jan. 1, 2014. As a consequence of losing the advantages of limited enrollment, Wallace believes New York Life Insurance Company would no longer underwrite the AVMA health plan.

"If the bona fide association designation goes away, then GHLIT medical plans would change as we know them today," she said.

Wallace noted that most states had filed suit in federal court challenging the constitutionality of the Patient Protection and Affordable Care Act, and the Supreme Court will hear arguments in March 2012, with the final ruling expected in late summer.

Appearing with Wallace at the VLC was GHLIT chair Dr. James H. Brandt to highlight features and benefits of the AVMA health plan. With more than 17,000 policyholders, for example, GHLIT covers approximately 36,000 veterinarians and their families. More than $118 million in claims was paid out in the past fiscal year, Dr. Brandt noted. Policy benefits he mentioned were guaranteed coverage regardless of health status, portability, and year-round enrollment.

Although New York Life Insurance Company underwrites this AVMA health insurance plan, it is managed by a trustee board composed entirely of veterinarians, Dr. Brandt said.

GHLIT is lobbying Congress and federal regulators to preserve bona fide association plans in the new rules, Wallace announced, and she called on veterinarians to do the same. The Trust has issued a white paper on this and other concerns about the new health care law and posted an issue brief online at www.avmaghlit.org.

"President Obama promised that Americans who liked their health insurance would be able to keep it under the new health care reform law," Wallace said. "The goal of your GHLIT is to see that the president keeps his promise to AVMA members."