Turf Battle or Promising Partnership? Understanding Marketplaces’ Responsibility to Offer Affordable Health Insurance

Implementing the ACA

Local press in D.C. recently reported on a “turf battle” between the health insurance marketplace and DC’s Department of Insurance over the review of proposed rate increases. But their roles are more complementary than conflicting. Sabrina Corlette examines how the Affordable Care Act envisions the marketplaces and state insurance departments working together to help consumers obtain better, more affordable health insurance. Continue reading

New Issue Brief Reviews Employee Choice in Small Business Health Options Program (SHOP) Marketplaces

Implementing the ACA

The Affordable Care Act (ACA) aims to improve access to health insurance coverage for small-business employees by creating a Small Business Health Options Program (SHOP) Marketplace in every state. One key feature of SHOP Marketplaces is employee choice whereby employees can select among multiple insurers and plans for health insurance coverage that best suits their needs. CHIR’s Sarah Dash and Kevin Lucia review how SHOPs are implementing employee choice in a new Health Policy Brief published by Health Affairs. Continue reading

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