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.
Overview of Final Exchange Regulations
Manatt Health Solutions
On March 12, 2012, the Department of Health and Human Service (HHS) issued final and interim final rules governing the Establishment of Exchanges and Qualified Health Plans; and Exchange Standards for Employers under the Patient Protection and Affordable Care Act (ACA). These final rules represent the most significant guidance to date on the operation of Exchanges, setting forth the minimum standards Exchanges must meet, including: those related to eligibility and enrollment into qualified health plans and insurance affordability programs; the minimum requirements for issuers to offer plans through the Exchange; and, the standards for employers to participate in the Small Business Health Options Program (SHOP).
The purpose of this document, authored by Manatt Health Solutions, is to provide an overview of the final rules. Section I provides a high level overview of important highlights, focusing on key areas where HHS has changed or expanded upon previous guidance. Section II provides a more detailed summary of the regulations.