The National Association of Insurance Commissioners (NAIC)—a standard-setting and regulatory support organization governed by insurance regulators from the 50 states, DC, and five U.S. territories—held one of its three annual meetings from August 11 to August 14 in Atlanta, Georgia.
Although this was the NAIC’s first meeting since the Supreme Court upheld the Affordable Care Act (ACA) and states face tight deadlines in implementing the ACA, some NAIC observers—including CHIR’s own Sabrina Corlette on the Community Catalyst blog—noted that the NAIC’s committees, working groups, and task forces “largely chose to kick the can down the road.” For example, the original agenda of the Market Regulation and Consumer Affairs (D) Committee included an item to “Discuss ACA Enforcement and State Coordination,” but this topic was dropped before the meeting. And the Regulatory Framework (B) Task Force discussed drafts of new model state laws to help regulators implement the ACA’s 2014 reforms, but did not vote to advance these models. Here are some other noteworthy items from the NAIC:
- A new working group on ACA alternatives. The Health Insurance and Managed Care (B) Committee appointed a new working group, known as the “Health Care Reform Regulatory Alternatives (B) Working Group.” This Working Group is charged to:
- “1) provide a forum for discussion of and guidance on the alternatives to implementing a state-based exchange compliant with the federal Patient Protection and Affordable Care Act (PPACA) and the implications of such alternatives on NAIC members’ regulatory authority;
- 2) assist members in resolving open issues related to non-state exchange PPACA alternatives;
- 3) analyze the impact of PPACA on member regulatory authority inside and outside a federal exchange and analyze the impact of existing NAIC model laws; and
- 4) identify opportunities for members to innovate and regulate outside a federal exchange.”
- A lively debate on stop loss regulation. The ERISA (B) Working Group heard lively debate during a discussion on the regulation of stop-loss coverage. In response to concerns raised by small businesses as well as some insurers and brokers, the Working Group released a memorandum answering questions about its process and the study used to support the NAIC’s actions. Although the NAIC has deferred the issue until a later date, here are some of the perspectives from the meeting (in addition to the comments received) which are expected to resurface as the debate continues:
- While some NAIC regulators voiced that fixing the problem should be a “no brainer,” others—including the Society of Professional Benefit Administrators and the American Insurance Association— testified that the Guideline Revision was unnecessary because few states had adopted the Model Law and that regulatory efforts should be refocused on the education of agents and brokers (rather than the regulation of stop loss coverage).
- In contrast, the NAIC consumer representatives urged the Working Group to issue a guideline revision as well as amend the Model Law. They stressed that the NAIC’s failure to act could destabilize the state’s exchange as only sicker small businesses enroll in coverage and most hurt small businesses and consumers.
- An update on the essential health benefits timeline. According to a bulletin and frequently asked questions issued by HHS, states must identify a benchmark plan for their essential health benefits standard by the end of the third quarter of 2012 – in other words, September 30, 2012. When asked to confirm whether there is now a new “soft deadline” for states, federal regulators at the Health Insurance and Managed Care (B) Committee’s meeting noted that states were still expected to select a benchmark plan on or about October 1, 2012. Once this selection is made, HHS will identify each state’s benchmark plan (or, if a state fails to do so, the state’s largest small group plan) in a draft notice of some kind.
- A new report on implementing the 2014 reforms. The NAIC consumer representatives released a comprehensive report with recommendations for state and federal officials on implementing the 2014 insurance market reforms in a way that most benefits consumers. Learn more about the report here.
Count on CHIRblog to keep you up-to-date on these and other NAIC issues as they develop!