Insurance Exchanges

The Department of Health and Human Services (HHS) has released its proposed rule regarding training and meaningful access standards for navigators and other personnel who will help individuals shop for health insurance in the new health exchanges. 

This brief explores how states may be able to use CHIP to help meet some of the child-specific requirements for exchanges in the ACA. Options for doing so include: using CHIP as model for pediatric benefits and providers in the exchange; using CHIP funds to provide premium assistance for eligible children to buy exchange coverage that would allow families to be insured by one coverage program; and using CHIP to wrap around Essential Health Benefit benchmark benefits to ensure children’s unique needs are met.

This report examines the ACA’s 3:1 age rating band, which stipulates that premiums for adults age 64 can be no more than three times higher than the premiums for adults age 21 for the same coverage, and its impact on health insurance premiums. 

HHS has issued its proposed rule for the Small Business Health Options Program (SHOP), which highlights special enrollment periods for the small-business exchanges and proposes policies for facilitating the transition for employers entering the new marketplaces. It also announced that the employee choice and premium aggregation components of SHOP will not be required until January 1, 2015, delaying them by one year.

The Office of Personnel Management (OPM) released its final rule on how it will administer two multi-state plans (MSPs) on insurance exchanges nationwide. While the final rule has not changed substantially from the proposed rule, it does finalize the provision giving MSP issuers the choice to either offer coverage that meets the standards set by the state benchmark plans or those of OPM’s benchmark plans.