Non-Profit Health Plans Want Tax-Status Disclosure on HIX

John Commins, October 10, 2014

Research has shown that consumers "do think there is a difference," between for-profit and not-for-profit health plans, says the head of an industry group. But in the final rule on health insurance exchanges, CMS has declined to require that tax-status be disclosed.

Nonprofit health insurance plans continue to dominate customer satisfaction and quality lists, and they want consumers to know about it.

Bruce McPherson, president and CEO of the Alliance for Advancing Nonprofit Health Care, says federal and state health insurance exchanges should do more to make the tax status of health plans readily available to consumers.

"The research has shown that consumers do think there is a difference and it is important," McPherson says. "Right now both in the federal exchange and the state exchanges under the federal rules for every plan that is offered they have to provide consumers with a summary of benefits and coverage form. All of the key information is there for the consumer in a user-friendly format. The one item that we had urged (the Centers for Medicare & Medicaid Services) to include would indicate if it's a non-profit or a for-profit health plan."

In the end, CMS declined to include that tax-status in the final rule.

"They provided no explanation. They didn't comment on our request. I could not get a straight answer out of them," McPherson says. "I am going to try to get all of the nonprofit health plans together, as many as I can, to make a big push in Washington to get this changed.

McPherson says a Zogby telephone survey from 2010 found that two-thirds of respondents didn't know if their health coverage was provided by a for-profit or a nonprofit plan, even though 75% of the respondents said they felt the distinction was important.  

John Commins

John Commins is a senior editor at HealthLeaders Media.

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