A Strategic Approach for Insurance Exchanges to Select and Manage Qualified Health Plans

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). Section I of this brief describes many of the types of decisions that Exchanges should consider in preparing to launch a clean, effective QHP solicitation process. Section II describes the standards that Exchanges will use to certify QHPs. It also summarizes the major federal requirements that all QHPs must meet and sets forth examples of additional requirements that some states are considering. Section III sets forth options for “negotiating” key elements of the issuers’ proposals.