ELLSWORTH — A federal Appeals Court judge, ruling in the state’s favor, has left intact a law requiring insurers to provide access to a school system’s insurance claims history.
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ELLSWORTH — A federal Appeals Court judge, ruling in the state’s favor, has left intact a law requiring insurers to provide access to a school system’s insurance claims history.
At issue is a school district’s ability to solicit competitive bids for school employees’ health care plans. That ability, according to the superintendent of insurance for the state of Maine, would be supported and enhanced if school districts had access to underwriting data and employees’ claims history.
Last year, the legislature enacted a law sponsored by Rep. Ralph Sarty (R-Denmark) designed to give school districts access to information that would assist them in finding the most affordable provider. The law is titled “An Act to Allow School Administrative Units to Seek Less Expensive Health Insurance Alternatives.”
The Maine Education Association’s Benefits Trust has been fighting the law granting access. The Trust, which manages a statewide health insurance plan covering most of Maine’s public school work force, said claims history is a trade secret and the disclosure required by the law constituted an uncompensated taking, which is disallowed by the Fifth Amendment.
Initially, the Trust sought an injunction. A District Court judge denied that request. The Trust appealed that denial to the U.S. Court of Appeals for the First District. Last month, the Appeals Court upheld the lower court’s ruling.
Anthem, the Trust’s insurance provider, is now required to release claims information when requested by a local school board.
Stephen Fay, managing editor of The Ellsworth American since 1996, is a native of Northern California. He writes The American's weekly wine and DVD reviews and covers breaking news.
Website: ellsworthamerican.com