Monday, October 15, 2007

Federal judge expected to rule on OGB implementation of Act 479 following October 12 hearing

The Office of Group Benefits will delay implementing a second annual open enrollment period until a decision is rendered by a federal court to decide whether the agency will be required to contract with Louisiana-based companies to provide additional health insurance plans to state workers.

U.S. District Judge Ralph Tyson of the Middle District Court of Louisiana is expected to rule within 10 days on whether the Office of Group Benefits can legally implement Act 479, a new state law that took effect July 17. A hearing on the matter, which began September 14, concluded on October 12.

Both Humana and United Healthcare filed challenges in federal court to prevent implementation of Act 479, which took effect July 17. A September 10 temporary restraining order remains in effect until the ruling is issued. The order bars OGB from awarding additional contracts to Louisiana-based health insurance companies and suspends preparations for a second annual enrollment period originally set to begin September 17.

Authored by Rep. Charles McDonald of Monroe, Act 479 directs OGB to contract with up to three Louisiana-based insurance companies in each region to provide fully-insured HMO plans in addition to the self-insured EPO, PPO and HMO plans
OGB now offers.

The new law also directs OGB to reopen annual enrollment within 60 days. The additional 30-day enrollment period would give 138,000 state workers, school employees and retirees another chance to choose a health plan for the 2007-08 plan year, which began July 1.

It is possible OGB will not be able to implement Act 479 until a judgment is rendered by the court and any subsequent appeals are resolved,” noted Tommy D. Teague, OGB chief executive officer.
“If Act 479 is upheld, OGB will reopen annual enrollment, and changes in coverage will take effect January 1.”

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