Enacted into law in 2018, the Healthcare Stability Plan was created to stabilize or even reduce the cost of individual health insurance plans, and also to increase the number of health insurers in the individual market.
According to the plan, a health insurer may be reimbursed for a portion of claims insured in the prior calendar year.
The plan, financed primarily through federal funds, is administered by the Office of the Commissioner of Insurance. The Commissioner’s office reimbursed health insurers $174 million in 2020, and $184 million in 2021.
The audit report found the Office of the Insurance Commissioner did not follow its own policies for selecting individuals and the claims in their own 2020 audit of the program. Therefore, the Audit Bureau said the office needs to improve how it processes the claims for reimbursement. The audit also found the number of individual insurance plans increased in thirty-nine counties.
Senator Robert Cowles (Green Bay), co-chair of the Joint Committee on Audit, said, “…enrollees in the individual healthcare plans saw an average monthly savings of $102 in lower premiums by the second year. I am pleased to see that this plan was able to help thousands of Wisconsinites with incredibly high insurance claims and contribute to lowering costs on families.”
The audit report covered the plans effects through 2020, the second year of the plan.
The Audit Bureau recommends the Office of the Insurance Commissioner report to the Joint Legislative Audit Committee in June 2022 on the extent to which the plan met specific goals over the plans first three years.
