NovaRest Founder Donna Novak and Wayne Novak recently returned from the National Association of Insurance Commissioners (NAIC) summer meeting that was held in Atlanta, GA. During the conference, they attended the Health Insurance Exchange Forum meeting. “This meeting was extremely informative and packed with discussion groups on the current status of each state’s status of exchange implementation,” said Donna.
States will have three options when setting up the exchange. They may set up a State Based Exchange (SBE) which gives the state all responsibility as it relates to the exchange. The second option is to set up a Plan Management Partnership Exchange (Partnership), which gives the state primary responsibility for plan management. And finally, the third option is to do nothing, which would result in a Full Federally Facilitated Exchange (Full FFE). With this option, the state will leave up all aspects of the exchange to the federal government.
Many states are still deciding what option they will implement. Some are waiting for federal guidance before implementation plans can be finalized.
NovaRest was also informed of other important outstanding issues, including the status of the actuarial value (A/V). The federal actuarial value and state definition of essential benefits have to be finalized before states can review rate and form filings. It appears that the System for Electronic Rate and Form Filing (SERFF) is being widely reviewed by insurers and states to determine if this will be the appropriate media to use for rate and form filings. State representatives will able to give feedback to NAIC and SERFF staff regarding what state specific data sets may be needed for plan approval for the Exchange as well as how network adequacy data can be collected. “As always the meeting was filled with informative sessions and the ability to connect with what is happening within the health care market,” said Donna.
Please stay tuned for more updates on the NAIC Summer meeting.