In 2019, the Washington legislature enacted a bill requiring insurers on the state’s health insurance exchange to offer plans with standardized benefit designs, beginning in 2021. Colorado and Maryland are considering similar requirements. As these and other states consider the option of standardized health plans, they can benefit from the experiences of California, the District of Columbia (D.C.), Connecticut, Massachusetts, New York, Oregon, and Vermont, all of which require insurers to offer standardized benefit designs. This Expert Perspective outlines benefits and risks of plan standardization, and raises critical questions that states will need to consider, and offers a decision roadmap for states implementing a standardized benefit design requirement.
Consumer Impact Analysis Presentation
Wakely Consulting Group – Julia Lerche
As the 2015 open enrollment period approaches, one of the most significant challenges faced by marketplaces stems from the complicated nature of premium subsidy calculations, which may lead to potentially large swings in consumers’ after-subsidy premiums and could have tax liability implications. While marketplaces are attempting to make the renewal process as smooth as possible for consumers by facilitating auto-renewals into QHPs and, in the case of the FFM, rolling over 2014 APTCs into 2015, this approach could potentially be detrimental to some consumers, depending on factors such as income changes, premium variation, or a change in the benchmark plan. This slide deck was presented by Julia Lerche of Wakely Consulting Group on a Medicaid affinity group conference call facilitated by the State Network on August 5, 2014, along with a white paper describing the issue, and provides several scenarios in order to explain the potential impact of rate changes on consumers. This information can be utilized to inform modifications to carrier notices and communication planning (messaging, targeted outreach, education) for consumers, navigators/assistors and the media.