…numbers and effect on premiums and health care costs in states where they are competitive, but what regulators really wanted to hear was how the CO-OPs were dealing with financial challenges. CHIRblog readers will be familiar with the challenges most CO-OPs are facing; an analysis found all but one of the 23 CO-OPs are running at a loss based on…
By Sabrina Corlette, Kevin Lucia, Justin Giovannelli and Sean Miskell The failure of the health insurance CO-OP operating in Iowa and Nebraska and recent analysis documenting significant losses among all but one CO-OP have caught the attention of policymakers and raised questions about the long-term viability of the Affordable Care Act’s Consumer Operated and Oriented Plan (CO-OP) program. The nonprofit,…
…placed his total trust and confidence in us. He had a great policy mind and deep intellectual curiosity. More fundamentally, he was a good, thoughtful and kind person. For the health policy community that knew him and loved him his loss is a giant void that will be deeply felt for a long time. Thank you Andy. We miss you….
…definition of full time work and the Obama administration recently opted to delay implementation of rules regarding insurance standards for the coverage that businesses provide their employees. But the ACA’s Small Business Health Options Program (SHOP), the marketplace for small businesses and their employees, has received less attention from lawmakers and employers alike. SHOP marketplaces were envisioned as online, one-stop-shopping…
…stronger chance than ever that your employer wants to help you with that resolution. More employers are offering workplace wellness programs. An annual survey of employer-provided health benefits found 3 out of 4 firms that offer health benefits offer some kind of wellness program, such as weight loss programs, biometric screening, nutrition counseling, or lifestyle coaching. Linking that program to…
…check. Back in the early 1990s, New York required insurers to sell to all comers, regardless of health status, but they didn’t require healthy people to maintain health coverage. As a result, premiums went through the roof, insurance companies stopped selling, healthy people dropped out, and the individual market all but collapsed. It was the proverbial insurance “death spiral.” Although…
…purchased a policy has stopped taking new patients by the time the enrollee attempts to schedule an appointment. Another regulatory option is to require prominently displayed announcements both online and on all narrow network plan print materials that state the network is limited and urge shoppers to review the provider directory before choosing a policy. There are all sorts of…
…the current federally based Marketplace system automatically dis-enrolls her from her health plan, if she purchased both at the same time. In this case, the enrollee was advised that, to keep her health plan but drop her SADP, the only way to do so is to stop paying premiums for the SADP but continue to pay premiums for her health…
…federal regulators decided early on to delay implementation of some of the new quality reforms in the law so they could focus on core operational issues. But that didn’t stop some states from recognizing the potential of the marketplaces to drive quality improvement and moving forward on their own. In their latest issue brief for The Commonwealth Fund, Sarah Dash,…
…month of the grace period). If a policyholder doesn’t pay all their outstanding premiums by the end of the grace period but actively selects a plan for the new benefit year, then the insurer cannot terminate their coverage in the new plan. And if a policyholder receiving an APTC once again stops paying premiums, insurers must provide a new 90-day…
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