In light of recent postal delays and housing displacements caused by the COVID-19 pandemic and related economic crisis, and a wave of natural disasters across the country, state Medicaid and Children’s Health Insurance Program (CHIP) agencies face new challenges communicating with their enrollees about their health coverage. Acting now to mitigate these challenges is essential as states are preparing for the end of the public health emergency (PHE) and “catching up” on coverage renewals for a large portion of their enrollees. This expert perspective reviews strategies that state Medicaid and CHIP agencies may consider to help mitigate coverage losses.
Premium Allocation and Employer Contribution Strategies for SHOP
Wakely Consulting Group – Jon Kingsdale and Mary Hegemann
This brief, prepared by Wakely Consulting Group, analyzes different options for premium rating methods for the Small Business Health Options Program (SHOP) Exchange. The details of the billing/employer contribution approaches are explored and insights are given into the benefits and challenges of each method. A key challenge in promoting employee choice in the SHOP is developing premium rating methods that do not discriminate against older employees, but that will support (a) employee choice of health plans based on value (including premiums), (b) a defined employer contribution, (c) a fair allocation of premiums among issuers, and (d) a premium invoice which employers can understand. This brief explores six options that SHOP exchanges can consider for resolving these issues.