$1.3 M federal grant given to improve health insurance coverage

The Illinois Department of Insurance recently received a $1.3 million federal grant. The DOI will use the Health Insurance Enforcement and Consumer Protections Grant to improve consumer and healthcare provider outreach.
The Illinois Department of Insurance recently received a $1.3 million federal grant. The DOI will use the Health Insurance Enforcement and Consumer Protections Grant to improve consumer and healthcare provider outreach.

$1.3 M federal grant given to improve health insurance coverage

By Safiyyah P. Muhammad

The Department of Insurance (DOI) was recently granted $1.3 million dollars in federal funding to improve consumer and healthcare provider outreach. According to a DOI press release, the grant will provide more resources for DOI health plan and oversight data analysis.

“The Department of Insurance (DOI) will use the Health Insurance Enforcement and Consumer Protections Grant to educate commercial health insurance consumers about their insurance coverage including parity in mental health and substance use disorder benefits, coverage for preventative health services and the appeals process when treatment is denied. It will also be used to develop standard operating procedures and best practices to identify discriminatory benefit design,” said Michael Batkins, a media spokesperson for the Department of Insurance.

Acting Director of DOI Anne Melissa Dowling said, “We are always searching for opportunities to raise awareness that our Department is here to help Illinois. These funds will help extend our outreach.”

According to Batkins, the grant does not apply to Medicaid enrollees. He stated that the updated coverage information will be for consumers who purchase commercial insurance (both on the Exchange and off the Exchange.) He said, “DOI will use the grant funds to improve oversight, review, and consumer education regarding benefits in commercial health insurance plans. DOI does not administer or regulate Medicaid.”

Batkins stated that the funding would keep patients updated and informed about their health plans. He said, “Patients will not see a change in their coverage, but they will be better informed about the benefits and coverage provided by the plans that they purchase. When consumers have a better understanding of their coverage, they are more likely to obtain the appropriate care.” According to Batkins, DOI will use grants funds to:

• Require issuers to complete a parity compliance worksheet;

• Ensure plan compliance through form review and regulatory oversight;

• Examine consumer and provider complaint trends in connection with behavioral health and substance use disorder benefits parity and use complaint data analysis to form a basis for operational direction to better serve consumers;

• Create a consumer-friendly outreach campaign including in-person presentations, webinars, and educational material in various languages to raise awareness about the benefits included in commercial health insurance plans;

• Update DOI website to provide easy access to information for consumers, providers and health insurance issuers;

• Enhance the DOI website to receive comments, questions, and complaints from commercial health insurance consumers.

According to the DOI website, the Department of Insurance’s mission is to protect consumers by providing assistance and information, by efficiently regulating the insurance industry's market behavior and financial solvency; and by fostering a competitive insurance marketplace.

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