In the absence of federal legislation, states are actively seeking tools to reform their health care systems. While 1115 waivers rightly get a lot of attention, because of their ability to reshape state Medicaid programs, the Affordable Care Act’s Section 1332 waivers continue to be a promising avenue for states to stabilize their health insurance marketplace. SHVS is tracking state activity and has many resources, including a template, for states interested in pursuing a Section 1332 waiver.
Department of Insurance Tools for Plan Year 2015 Form Filings and Review Webinar
With the first open enrollment period having come to an end, states are immediately gearing back up to ensure that consumers again have strong plan options available on the Marketplace for 2015. Insurers will soon be filing forms and rates with state insurance departments, and regulators will be working through those filings to certify products to be offered on the Marketplace during the next open enrollment period. States also will be looking especially closely at issues like network adequacy, which have received much attention in the news in early 2014.
To that end, the State Network, through its team at the Georgetown University Health Policy Institute, has updated its form review checklists and created a number of new tools to help insurance regulators streamline the form review process. In this webinar, Sally McCarty and David Cusano of Georgetown University Health Policy Institute introduced department of insurance staff to these tools, discussed how to use them, and described some of the policy and operational considerations that regulators will want to consider during the form review process. Specifically, the webinar walked through the following resources:
- Network adequacy planning tool
- Individual market form review checklist
- Small group market form review checklist
- Catastrophic plan form review checklist
- Stand-alone dental form review checklist
- Qualified health plan issuer certification checklist
- Mental health parity and addition equity act issuer checklist and certification
- Issuer essential health benefits crosswalk and certification
The webinar slides can be found at the “download” button and a webinar recording can be found here.