Question on Stand-alone Dental Plans and Upcoming Open Enrollment

Implementing the ACA

With the change in weather, we’re beginning to field questions related to the upcoming 2015 Open Enrollment period as part of our technical assistance work funded by the Robert Wood Johnson Foundation. We recently received a question about the consequences of not paying premiums for stand-alone dental plans (SADP) in federally based Marketplaces. Sandy Ahn provides a summary on this issue. Continue reading

Do Nothing to Renew or Get an Updated Eligibility Determination? CMS Puts out Final Marketplace Renewal Rules

Implementing the ACA

Last week the federal Centers for Medicare and Medicaid Services (CMS) published final rules for the health insurance marketplaces and participating insurers to renew consumers into coverage for 2015. Our colleague from Georgetown’s Center for Children and Families, Tricia Brooks, discusses what the rule means for consumers and their families. Continue reading

Reforming State Regulation of Provider Networks: Efforts at the NAIC to Re-draft a Model State Law

Implementing the ACA

Almost two decades ago, the National Association of Insurance Commissioners (NAIC) adopted a model state law to regulate the adequacy of health plan provider networks. In the wake of consumer and provider concerns about narrow networks, the NAIC is revising the model law. Sabrina Corlette shares an update on their process and timing. Continue reading

The Next Frontier: Insurance Marketplaces That Promote Quality Improvement

State of the States

While most state-based marketplaces in 2014 are rightly focused on the operational challenges of connecting people with coverage, over time technical improvements will allow them to prioritize providing better quality, more cost-effective care to enrollees. CHIR experts Sabrina Corlette and Sarah Dash, in their latest blog post for the Commonwealth Fund, discuss the opportunities and challenges for states working to implement the ACA’s quality improvement initiatives. Continue reading

New Issue Brief Examines Specialty Drugs in Tiered Pharmacy Benefit Structures

Implementing the ACA

Health plans have been increasingly using tiered pharmacy benefit designs. These new designs raise challenges for consumers and the state insurance regulators responsible for reviewing and approving plans for sale. CHIR faculty members Sally McCarty and David Cusano explore these issues in a new brief for the Robert Wood Johnson Foundation’s State Health Reform Assistance Network. Continue reading

CHIR Launches First in Video Series: Coffee Conversations on Timely Health Insurance Topics

Implementing the ACA

We at the Center on Health Insurance Reforms are excited to share the first of an upcoming video series on timely health insurance topics. In our debut video, CHIR experts Sabrina Corlette, JoAnn Volk, and Dave Cusano provide a preview of upcoming action at the National Association of Insurance Commissioners’ (NAIC) national meeting to address concerns about network adequacy of health plans offered through the new health insurance Marketplaces. Continue reading