…used to ensure compliance with state law. In addition, consumers would continue to contact the state with inquiries and complaints about their coverage. In the face of a potential violation of federal law, states would refer the issue to CMS for possible enforcement action if unable to obtain voluntary compliance from insurers. As of March 1, 2013, four states—Oklahoma, Missouri,…
…to the lowest cost silver plans or a cheaper bronze plan, they could pay even less (down to zero dollars a month for some bronze plans), but, in doing so, they would lose access to complementary cost-sharing reductions if they choose any plan other than a silver plan. An individual earning 300 percent FPL (approximately $34,470 per year) would be…
…program, and changes in insurer administrative expenses, would have a downward effect on rates, however, and contribute to the finding of a composite change of 14 percent. The authors assume that buying more coverage – in other words, more comprehensive policies in terms of benefits and actuarial value – will increase premiums but decrease consumer cost-sharing. Milliman also looked at…
…self-insurance to obtain lower premiums and escape the consumer protections that apply to the traditional, fully insured market. Unfortunately, small employers who self-insure are not required to submit any data to DOL regarding their plan or their finances, so the report can give us no picture of what is happening in that market. Only employers covering 100 or more participants…
…publicly traded insurers did spend 50 percent more on the health IT component of quality improvement than their non-publicly traded counterparts. The second study, released yesterday by Catalyst for Payment Reform, is a first-ever national scorecard on progress with payment reform, using self-reported data submitted to eValue8, the National Business Coalition on Health’s annual Request for Information to health plans….
…for services for some people (including, for example, transgender people) that are covered for other people based on gender identity or expression. In both states, the bulletins pointed to existing state legal requirements—laws that prohibit unfair trade practices—as the basis for the interpretation. Because unfair trade practice laws are common, regulators in other states may want to consider doing the…
…the ACA. Federal outreach efforts are scheduled to kick into high gear this summer, while coalitions like Enroll America are planning their own, complementary outreach campaigns. Once people know coverage is available, then what? All this education and outreach will need to be accompanied by hands-on, in-person assistance to help people understand what they’re eligible for, compare coverage options, and…
…described in a recent bulletin, carriers may amend their current policies to end by December 30, 2013 and begin subsequent plan or policy years on December 31st. Because the ACA specifies that the 2014 reforms are effective for plan or policy years beginning on or after January 1, 2014, carriers would not need to come into compliance with the new…
…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…
…due them; and All plans sold outside of the Marketplace Exchange during the two-year transition period will be required to comply with all of the requirements applicable to coverage sold through the Exchange portal. The Exchange’s plan now needs to be approved via legislation by the D.C. Council, in a vote that could take place soon. However, in the wake…
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