MIGHT

WCA GROUP HEALTH TRUST

August 13, 2010

The Honorable Phyllis Borzi, Assistant Secretary
Employee Benefits Security Administration

U.S. Department of Labor

Washington, D.C. 20210

Attn: RIN 1210-AB42

The Honorable Jay Angoff, Director

Office of Consumer Information and Insurance Oversight
U.S. Department of Health and Human Services
Washington, D.C. 20201

File Code: OCIIO-9991-IFC

Re: Grandfathered Status of Health Plan Under the Patient Protection and Affordable Care Act

Position: Modifications to a Plan’s Provider Network or Self-funded Status Should Not Affect
Grandfather Status

Dear Ms. Borzi and Mr. Angoff,

On behalf of The WCA Group Health Trust, a jointly self-funded health plan covering approximately
10,000 county, city and school district employee lives throughout Wisconsin, I am writing to ask you to
give employers and health plans the flexibility necessary to focus on making high-value health care
available through their provider networks and urge you not to subject plans to increased regulations if
they opt to self-fund their health benefits.

We have been jointly self-funding benefit plans of local government employers for 20 years and
believe it is critical in providing quality, safe health care for employees, while giving local
governments the power to reduce administrative costs and effectively manage provider networks.
Without the unencumbered ability to remove a provider from the network due to poor performance or
higher than average costs, increases in costs will not be able to be effectively managed and benefit
levels will be in jeopardy.

22 EAST MIFFLIN STREET, SUITE 900 / MADISON, W1 53703 ¢ PH: 1.866 404.2700 / FAX; 608.663 7189 / www weaght org
Claims Administrator: Marketing/Consulting:
UMR Aegis Corporation
2700 Midwest Drive 18550 West Capitol Drive
Onalaska, WI 54650-8764 Brookfield, WI 53045
Phone: 1.800.236.2515 Phone: 1,800,236,6885
Fax: 608.783.8621 Fax: 262.781.7743


Page 2
Honorable Phyllis Borzi and Honorable Jay Angoff
August 13, 2010

Over the past several years, self-funded employers have become more engaged in managing employee
benefit plans through a variety of innovative programs committed to quality, safety and wellness. This
engagement has allowed our membership to better control costs and maintain strong employee benefit
programs. By subjecting self-funded plans to additional regulations you will discourage employers
from self-funding, which is likely to negate any employer investment gained over the past several
years.

The provisions of the Patient Protection and Affordable Care Act appear to support controls over costs
and quality of care. Self-funding and enabling changes to provider networks to promote high value
and save care. I urge you not to tie grandfathered status to their adoption.

Thank you for your consideration of these comments. If you have any questions, please do not hesitate
to contact me.

Sincerely,

sl GAnclf

fosh Bindl
Assistant Secretary, Trust Board

CC: The Honorable Herb Kohl
The Honorable Russ Feingold
The Honorable Tammy Baldwin
The Honorable Steve Kagen
The Honorable Ron Kind
The Honorable Gwen Moore
The Honorable David Obey
The Honorable Thomas Petri
The Honorable Paul Ryan
The Honorable James Sensenbrenner