Insurance Market Reform

New York's Department of Financial Services (DFS) released its approved premium rates for the insurers planning to offer coverage in the state’s state-based marketplace.

Policy experts predict that small employers, especially those with younger and healthier employees, will increasingly establish “self-funded” health plans, leaving the traditional fully-insured market to obtain lower premiums and avoid market reforms under the Affordable Care Act. Through interviews with stakeholders in 10 study states, this paper describes factors that may influence whether and how extensively this change will occur. It also shows that states have minimal data on this potentially growing market, but they would be well served to improve their monitoring efforts so they can identify any increases in small group self-funding and resulting adverse selection, and respond appropriately.

Stemming from training at insurance departments in various State Network states, Georgetown University Health Policy Institute (Georgetown) has released updated form review checklists. These resources are designed to help insurance regulators effectively implement Affordable Care Act (ACA) provisions, regulations, and other guidance by ensuring that insurance forms submitted by carriers meet all the ACA requirements.  They are in writable Microsoft Word document form, allowing insurance regulators to simply download and modify to their state’s specifications.

 This bill modified Maryland state law to conform with consumer protection and insurance market reform provisions in the Affordable Care Act.