On March 1, 2012 Wayne Novak attended the Health Insurance Exchange Plan Management Forum meeting at the National Association of Insurance Commissioner (NAIC) meeting in New Orleans, LA. The meeting covered many topics on how states can use the NAIC’s System for Electronic Rate and Form Filing (SERFF) to assist in the setup of exchanges. SERFF is not intended to be the complete solution to Exchange Plan Management (Exchange). The primary purpose is to handle functions related to the submission and certification of Qualified Health Plans (QHPs) and to minimize duplication efforts.
The NAIC is working to implement the essential Health benefits that are a part of the Affordable Care Act (ACA) into SERFF. They are also working to implement enhancements so that SERFF can be used to determine if plans are meeting both federal and state regulations for benefit offerings. There are currently many training opportunities available, including formal training and web tutorials, and states are encouraged to begin the training as soon as possible.
Joy Morrison from SERFF presented a progress report on the five project objectives (PO) and fifteen key business requirements (KBR). The PO included a more streamlined process for insurers submitting plans for inclusion on an Exchange and more flexibility to states in how they can use SERFF for Plan Management. Among the most important KBRs is the ability for state regulators to review QHPs and to determin their suitability for the Exchange. Also, the ability to decertifiy an insurer in total or to decertify one or more of an insurer’s plans. A full list of the POs and KBRs are not currently available at NAIC.org but can be requested by contacting SERFF.
The Technology Study Group is a highly collaborative group that includes six states, two insurers, Center for Consumer Information and insurance Oversight (CCIIO). This group is working to draft a data dictionary for the data elements that will be captured in SERF in support of Plan Management functions. The group is creating an XML schema the will used to collect data on the insurer, product, rates and etc.
A preliminary report is due to be released on March 30, 2012.