In our latest issue brief for the Commonwealth Fund, we examine states’ efforts to implement the Affordable Care Act’s requirement that health plans cover a minimum set of essential health benefits (EHB). We found that 24 states and the District of Columbia selected the EHB benchmark plan for their states and 26 states made no selection. Of those selecting a…
…of Insurance Commissioners (NAIC) and members come from organizations such as the American Cancer Society Cancer Action Network, Consumers Union, the American Heart Association, Health Access California and the Center on Budget and Policy Priorities, as well as academic centers such as Washington & Lee School of Law and Georgetown University. Beth Abbott of Health Access (California) noted: “We felt…
…wellness and health promotion, and increase the use of health care data through information technology (45 C.F.R. § 158.150). Quality rating system, enrollee satisfaction, and health plan value: The ACA also directs the Secretary of Health and Human Services to establish a quality rating system and enrollee satisfaction survey system, as well as developing a methodology for calculating the value…
…to are known as “Waivers for State Innovation.” There is a provision in the ACA (Section 1332) that allows states to apply for a waiver so long as the state’s proposed plan 1) provides coverage that is at least as comprehensive as the ACA’s requirements; 2) provides coverage for a comparable number of residents that would have received coverage under…
…self-insurance in the small group market but this percentage has not increased in over ten years. The National Association of Insurance Commissioners (NAIC) has also been looking into this issue as commissioners debated whether or not to increase the minimum attachment points in the group’s stop-loss model law. Supporters of the change argue that the current levels are out-of-date and…
…collecting the same data in the same format, it makes things easier for insurers and regulators. Database for insurers wishing to participate in FFE and SBE: CCIIO also clarified that insurers in SBE states would submit their data through SERFF, as would insurers in P-FFE states. However, insurers in FFE states will need to submit their information through a different,…
…the additional consumer protections a state has put in place will confuse consumers, leave some consumers with less protection than others and result in an unlevel playing field that could give the largest insurers additional competitive advantages in the marketplace, thereby undermining the goal of the [ACA] to create more competition in health insurance markets and strengthen consumer protection.” Advocates…
…on a number of areas, some of which were raised as consumer concerns in stakeholder meetings and comments. These areas include: Whether additional rules are needed to demonstrate compliance with the reward limits when the reward is variable, such as waived copays for outpatient visits when the number of visits will vary by participant; Whether additional rules are needed for…
…the rules of the road before they can design and develop plans that comply with the sweeping insurance reforms set to go into effect in 2014. Establishing the essential health benefits (EHB) package is just part of a series of proposed rules. The Administration also released new standards for the 2014 market rules (i.e., guaranteed issue, modified community rating, and…
…you more for a slew of factors, like being a woman or working at the wrong job; greater transparency and standardization, so consumers can make apples to apples comparisons of their plan choices; limits on how much consumers must pay out-of-pocket in a year; and new state-run health insurance marketplaces where consumers and small businesses can buy coverage – with…
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