Insurance Exchanges

Wakely Consulting Group has prepared this policy brief to aid state Exchanges in the process of certifying, recertifying, de-certifying and managing the relationship with qualified health plans (QHPs).

Consumers offered employer-sponsored insurance (ESI) can be ineligible for subsidies in health insurance exchanges (HIX), and until better ESI data become available, HHS proposes using post-enrollment audits, rather than pre-enrollment verification for this eligibility requirement. This paper examines two strategies through which exchanges can implement this policy by focusing audits on the consumers who are most likely to be ineligible.

In this brief, Manatt Health Solutions assesses the proposed rules that will determine the benefits and costs of plans that will be offered through health insurance exchanges (Qualified Health Plans or QHPs) and for many plans sold outside of exchanges starting in 2014.

On November 30 the U.S. Office of Personnel Management (OPM) released its proposed rules for the Multi-State Plan Program (MSPP) of the Affordable Care Act (ACA). This brief prepared by Manatt Health Solutions provides an overview of the key provisions of the proposed rule.

This brief reports on the key provisions of HHS's Notice of Benefit and Payment Parameters for 2014. This proposed rule covers topics including the federal risk adjustment model, reinsurance parameters, cost-sharing reduction payment methodology, and user fees for insurers offering QHPs in federal exchanges.