THE GAZETTE
Wednesday, July 31, 2013 p
Page A-7
State slices insurers’ requests for new exchange premiums Medical insurance program starts in October n
BY
KEVIN JAMES SHAY STAFF WRITER
The average 50-year-old nonsmoker in Montgomery County can buy health insurance premiums through the Maryland exchange market starting Oct. 1, ranging from $263 to $470 per month. The lowest monthly premium rate is from Coventry Health Care of Delaware, owned by Aetna, which operates in Maryland, Delaware, Pennsylvania and New Jersey. The highest is from All Savers Insurance, part of UnitedHealthcare. State insurance officials on Friday approved the rates for individuals that were as much as 33 percent below what insurers had requested. All Savers’ premium for the Montgomery 50-year-old was about 32 percent below what the insurer requested, while Coventry’s was some 27 percent below its request. Under the federal Affordable Care Act, individuals have to obtain health insurance by January or pay a penalty of either $95 or 1 percent of their annual taxable income next year. The penalty will rise to $325 or 2 percent of income in 2015 and $695 or 2.5 percent of annual income in 2016.
Maryland’s largest insurer, CareFirst BlueCross BlueShield, received approval to average $312 in monthly premiums for the average 50-year-old Montgomery resident, only 4 percent below what it requested. Rockville-based Kaiser Permanente of the Mid-Atlantic States received approval for an average of $381, only about 1 percent below its request. State insurance regulators approved rate changes based on input from actuaries and others who studied the insurers’ submitted plan designs and rates. Actuaries conducted statistical analyses and tested assumptions that insurance companies used to develop rates. Officials also made sure the plans complied with state and federal laws, and they considered public comments in deciding what level to approve. CareFirst’s offerings are “competitively priced and often among the most affordable options available,” officials said in a statement. “Rate adjustments imposed by the MIA were modest, and we look forward to the launch of the exchange this fall.” Kaiser “worked with Maryland officials to ensure our 2014 rates are as consumer friendly as possible. We believe all residents should have access to high quality, affordable care, and we’re confident our rates reflect that,” officials said in a statement.
Cardin disappointed in delay U.S. Sen. Benjamin L. Cardin (D) of Pikesville said he was disappointed that President Barack Obama recently agreed to delay until 2015 the employer mandate portion of the federal health care law, and that he didn’t support a similar delay in the individual mandate. “I don’t think a lot will change in a year,” Cardin said during a meeting Friday with Gazette reporters and editors. “But I understand the adminis-
Court: Gaithersburg bar is not liable in drunk-driving death Girl, 10, died in 2008 crash; driver convicted of manslaughter
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BY JULIE
ZAUZMER
THE WASHINGTON POST
Bars in Maryland cannot be held liable for injuries their patrons cause after they leave, Maryland’s highest court ruled Thursday in a 4 to 3 vote. The grandparents of a 10-year-old girl who was killed when a drunk driver hit their family car in 2008 sued the Gaithersburg bar that served Michael Eaton, the driver, 21 drinks before he hit the road. But the Court of Appeals ruled that the bar, Dogfish Head Alehouse, is not liable for the crash. In 43 states and Washingont, D.C., according to statistics compiled by Mothers Against Drunk Driving, vendors of alcohol can be held liable in at least some circumstances for accidents that occur after they serve drinks to a visibly intoxicated customer. Maryland, Virginia and Delaware are among the seven states that lack “dram-shop” liability provisions, as they are known. The others are Kansas, Nebraska, Nevada and South Dakota. The Rev. William Warr Jr. and his wife, Angela Warr, had hoped to change that in Maryland. In August 2008, Eaton ordered 17 beers and several drinks of hard liquor, including a shot of tequila and something called a lemon drop, according to court records. Then he drove between 88 and 98 mph along Interstate 270. He hit the Warrs’ vehicle from behind. Ten-year-old Jazimen Harris was killed, and the Warrs and another granddaughter were injured. Eaton was sentenced to eight years in prison for manslaughter, and the Warrs sued the bar. The court offered the same opinion that it gave in 1951 and 1981: Bars in Maryland are not liable for accidents their patrons cause, even if the bars fail to stop serving patrons who are clearly drunk. In her dissenting opinion, Judge Sally Adkins noted that public opinion on drunken driving has changed greatly since the last time the court considered dram-shop liability. The court suggested in 1981 and in Thursday’s decision that the legislature could choose to pass a dram-shop measure. But Adkins pointed out that four bills on the subject introduced from 1987 to 2012 never made it out of committee. Jason Fernandez, an attor-
ney who helped represent the Warrs, said legislators will not consider the topic because insurance companies resist the laws. “At some point in time, some branch of the government has got to step up and save lives,” Fernandez said. “The legislature couldn’t, so we asked the court to do so, and they chose not to.” In her dissent, Adkins cited a study that found dram-shop liability — the term comes from a term for a shop where spirits were sold by the dram — reduced fatalities by 3 percent to 11 percent. She calculated that in Maryland 14 people would be saved each year by such a provision. “The majority of the general public would be outraged at a commercial vendor who, for the sake of profit, continues to serve an already drunk person well past the line of being ‘visibly under the influence,’ to the point of becoming aggressive and violent, and then sends him on his way, where he gets behind the wheel of a vehicle and kills a tenyear-old girl,” she wrote. “By the standards of our community, this is morally blameworthy.”
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tration’s desire to want to make sure it’s done right.” The law will force employers with more than 50 full-time workers to pay a penalty if they don’t provide employees with health insurance starting in 2015. The penalty would be $2,000 per employee, minus the first 30 workers. For example, a non-providing company with 50 employees would pay $40,000. Cardin didn’t think a lot of employers would switch some of their full-time employees to part-time to get under the 50-worker threshold. “I would think that employers want to of-
fer health insurance to remain competitive,” he said. The law will provide medical insurance for thousands of Marylanders who are not currently covered, along with substantial benefits to individuals and employers, including eliminating exemptions for pre-existing conditions and providing tax credits to businesses and individuals, Cardin said. “It will be more popular than people think,” he said. Enrollment for small businesses with fewer than 50 employees to buy insurance through the Maryland marketplace will begin Jan. 1.
Employers with fewer than 25 employees and average wage rates below $50,000 are eligible for tax credits to offset part of the cost of medical insurance. The credits will offset up to 50 percent of the employer portion of premium contributions next year if purchased through the state marketplace. Individuals who buy their own insurance and whose income is less than 400 percent of the federal poverty level, or about $45,000 annually, are also eligible for tax credits. kshay@gazette.net