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Issue Brief , Regulatory Analysis

As the 2015 open enrollment period approaches, one of the most significant challenges faced by marketplaces stems from the complicated nature of premium subsidy calculations, which may lead to potentially large swings in consumers’ after-subsidy premiums and tax liability implications.

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Date Created: Aug 7, 2014


Meetings & Presentations , Regulatory Analysis , Work Plans & Timelines

The State Network hosted a Small Group Convening in Boston, MA on July 10-11, 2014, bringing together state officials and technical experts to discuss QHP and IAP renewals in advance of the upcoming open enrollment period. The meeting provided officials from several states within and outside of State Network an opportunity to discuss strategies for confronting potential issues related to the renewals process.

Date Created: Jul 18, 2014


Issue Brief

All-payer claims databases (APCDs) collect and compile medical, pharmacy, and sometimes dental claims, eligibility, and provider files from public and private payers. APCDs are currently being used for a variety of functions, including population health analysis, comparative analysis of provider and facility quality, cost management for Medicaid and other public programs, support for provider payment reform initiatives, and consumer transparency tools.

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Date Created: Jun 27, 2014


Issue Brief

Under the Affordable Care Act (ACA), individuals seeking health insurance coverage through a Marketplace are assessed for eligibility for an advance payment of the premium tax credit (APTC) based on projected annual income. When eligible individuals file federal income taxes at the end of the year, the Internal Revenue Service (IRS) will reconcile the premium tax credit received based on estimated annual income with what should have been received based on actual income.

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Date Created: Jun 23, 2014


Issue Brief

he Affordable Care Act (ACA) is already greatly expanding individual health insurance coverage, particularly among lower-income uninsured individuals. However, this is neither easy nor inexpensive to sustain, and it will require ongoing, effective public-private partnerships on multiple levels. One potential partnership opportunity is with “web brokers” who sell individual health insurance online, functioning as private distribution channels in a fashion similar to the new Marketplaces and offering a choice of health plans from multiple insurers, while relying primarily on websites and call centers for customer service.

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Date Created: Jun 19, 2014


Issue Brief , State Materials

With full implementation of the health insurance coverage provisions of the Affordable Care Act (ACA) on January 1, 2014, there has been great interest in assessing the law’s early impact on health insurance coverage in Minnesota.

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Date Created: Jun 17, 2014


Webinar

Departments of insurance and insurers are currently preparing for the next round of rate development, filing and review. Rates for 2014 were developed based on considerable speculation on the expected impact of the ACA market reforms on the number and health risk of individuals who would enroll. Early enrollment information will be available for the 2015 rate development and review process, however, robust health risk information may still be unavailable.

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Date Created: May 7, 2014


Webinar

With the first open enrollment period having come to an end, states are immediately gearing back up to ensure that consumers again have strong plan options available on the Marketplace for 2015. Insurers will soon be filing forms and rates with state insurance departments, and regulators will be working through those filings to certify products to be offered on the Marketplace during the next open enrollment period.

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Date Created: Apr 3, 2014


Templates & Toolkits

The Mental Health Parity and Addiction Equity Act (MHPAEA) Issuer Checklist and Certification has been developed by the Georgetown University Health Policy Institute for use by insurance regulators in reviewing products filed by issuers for compliance with MHPAEA.

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Date Created: Mar 27, 2014


Templates & Toolkits

The Issuer Essential Health Benefits (EHB) Crosswalk and Certification has been developed by the Georgetown University Health Policy Institute to help insurance regulators ensure that product filings include the required EHBs as set forth in the applicable state benchmark plan. Regulators can use the tool provided here, requiring issuers to complete the Crosswalk and Certification

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Date Created: Mar 27, 2014