Insurance Exchanges

Maryland Health Benefit Exchange has issued an RFP to procure a contact center, called the Consolidated Service Center (CSC) to support Maryland consumer inquiries for exchange services. The CSC will need to be easily accessible via toll free number and website with live agent support; utilize culturally and linguistically appropriate communication channels; provide safeguards to ensure customer privacy and data security; provide clear, accurate, responsive information tailored to meet Maryland consumer needs; and be fully compliant with American Disabilities Act requirements.

This analysis was prepared to assist in planning for the design, implementation, and operation of a successful SHOP Exchange in New York State. It provides an overview of state and federal laws and regulations relating to the design and implementation of the SHOP; identifies potential options and decision points related to the design of the SHOP; summarizes other states' approaches to developing a SHOP; and provides a SHOP concept of operations, including the identification of key SHOP business processes.

With the passing of the partnership deadline on February 15, 26 states have defaulted to the Federally Facilitated Exchange (FFE), and it will now be the responsibility of the Department of Health and Human Services to get the exchanges up and running in these states. This brief provides an overview of the requirements necessary to establishing a FFE and the challenges that the federal government may face in implementing them in 26 different states. 

HHS released the final rule on essential health benefits (EHB), actuarial value, and accreditation of qualified health plans. This rule finalizes the state benchmark approach for defining EHB in 2014 and 2015. It also sets forth limits on cost-sharing, allows for a slight leeway – plus or minus 2 percent – in the actuarial value of the metal level requirements, and finalizes the drug coverage requirements in the exchange.

The Center on Budget and Policy Priorities has updated its guide “State Policy Decisions in State-Based Exchange Implementation”. This guide is a compilation of the policy decisions states will need to make when building a state-based exchange. This guide identifies areas where states have flexibility in the design of their exchanges and helps advocates, policymakers, and other stakeholders look for ways to get involved in this process.