NAIC Tackles Consumers’ ACA Questions: Subgroup Prepares Educational Materials for State Departments of Insurance

The National Association of Insurance Commissioners (NAIC) has recently reconstituted a health reform-related subgroup called the “Consumer Information” subgroup. The group, composed of state insurance regulators, insurers, consumer advocates, and provider representatives was originally created as a mandate in the Affordable Care Act (ACA) to develop the Summary of Benefits and Coverage (SBC) and a uniform glossary of health insurance terms. I was appointed to the subgroup as a consumer representative in 2010, and continue to serve in this capacity. After almost a year of work and significant input from a variety of stakeholders, we submitted recommendations to the U.S. Department of Health and Human Services (HHS), which the agency adopted with few changes.

Fast forward another year and the NAIC has reconvened the Consumer Information subgroup, this time with a charge to “develop information that would be helpful to state regulators and others in assisting consumers as Health Benefit Exchanges begin their work in 2013 and 2014.” To this end, the subgroup has begun drafting a template set of “Frequently Asked Questions” (FAQs) that state insurance departments can make available to consumers or use to train their consumer hotline staff. To date, NAIC staff have compiled a preliminary list of questions commonly posed to state DOIs. These range from “What is an Exchange?” to more technically complicated questions such as, “Can one spouse stay in employer coverage while the other purchases individual coverage in the Exchange?”

Today, the Consumer Information group held the first of what are likely to be many open calls as the members work to prepare these materials. On the call, it was agreed that members will now start drafting consumer-friendly answers to those questions with the goal of sharing preliminary drafts during our meeting at NAIC’s national conference April 5-9 in Houston, TX.

As Exchanges are launched and the news media and policymakers turn their attention to the oncoming changes to the insurance markets, many consumers will undoubtedly turn to their insurance departments with questions and for help. The NAIC’s efforts to draft a standard set of consumer-friendly materials that can be used by insurance regulators nationwide will help consumers get timely and accurate answers to their questions.

For more information on NAIC’s ACA implementation work, stay tuned to CHIRblog.

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