VICE CHAIRMAN SHARP introduced SB 313 (HEALTH INS. FOR HIGH RISK RESIDENTS) as the final order of business before the committee. CAROL CARROL, staff to Senator Kerttula, explained that SB 313 would amend the Health Insurance Association set up 1992 for high- risk health insurance. She reviewed the amendments to SB 313 which are present in the committee's packets. SENATOR LEMAN asked for a description of the " other managed care arrangements " which can be found on page 1, line 10. CAROL CARROL L said that a provider type arrangement, a preferred provider arrangement would be an example. BOB NIEBRUGGE, Consumer Representative of the Comprehensive Health Insurance Association, agreed with the preferred provider arrangement example which Providence Hospital may be able to fulfill. He said that HMO's may be able to offer care at a cheaper rate in the future. SB 313 provides language to offer health care insurance at a cheaper rate to the insurers and make it as accessible as possible. SENATOR ELLIS asked why Senator Kerttula's original legislation had five insurance representatives and two consumer representatives on the board. BOB NIEBRUGGE stated that the five insurance representatives were beneficial with the technical tasks to create the legislation. The composition of the board has been successful. SENATOR ELLIS inquired as to Mr. Niebrugge's background. BOB NIEBRUGGE explained that he was a self-employed diabetic, a pre- existing condition. Eventually, he did discover Communicating for Agriculture, which had created a high risk pool. Under Communicating for Agriculture, insurance was available at an elevated premium without any subsidies. SENATOR ELLIS asked if Mr. Niebrugge had any suggestions for those individuals who cannot afford the elevated premium. BOB NIEBRUGGE said not in the context of this legislation. SENATOR ELLIS said that was the point. SENATOR ELLIS noted that SB 313 references HMO's and previous legislation from Senator Kerttula attempting to help HMO's to do business in Alaska. Still, HMO's are not coming to Alaska. He asked if there was hope for HMO's in Alaska. BOB NIEBRUGGE said no, this is an attempt to clean up the language in this legislation. SENATOR ELLIS inquired of the background of the other consumer representative on the Association. BOB NIEBRUGGE explained that Elaine Hurley was the other consumer representative who has a daughter with a pre-existing health condition. Number 416 SENATOR DUNCAN asked Mr. Niebrugge if he had insurance through the high risk pool. BOB NIEBRUGGE said no, he has a group plan. In response to Senator Duncan, Mr. Niebrugge stated that they had approximately seventy-some applications for the high risk pool. SENATOR DUNCAN asked Mr. Niebrugge to clarify the number of individuals who actually received insurance. BOB NIEBRUGGE said that seventy-two individuals were actually insured. Mr. Niebrugge suspected that very few individuals would be declined, due to their initial information when applying. SENATOR DUNCAN stated that these changes seemed to make sense, but would SB 313 change the number of individuals joining the high-risk pool. BOB NIEBRUGGE explained that the original legislation only provided three levels of deductibles; most individuals opt for the higher deductible because it has the lowest premium. Mr. Niebrugge indicated that if these changes occur in SB 313, a higher deductible similar to a catastrophic plan would be offered. This type plan would substantially decrease premiums which would help enrollment. SENATOR DUNCAN inquired as to other states' deductible under a high-risk pool. BOB NIEBRUGGE noted that there are a variety of programs, but they generally lean toward the higher deductible. Mr. Niebrugge offered to provide the committee with a publication of other states' programs. SENATOR DUNCAN asked Mr. Niebrugge about his group policy. BOB NIEBRUGGE explained that his group policy was with a company that had opened their enrollment to high-risk individuals for a short time. SENATOR DUNCAN inquired as to the status of his premium. BOB NIEBRUGGE stated that his premiums have gradually increased. SENATOR MILLER moved SB 313 out of committee with individual recommendations. Hearing no objections, it was so ordered.