Webinars | Mar 5, 2015

Webinar: Considerations for 2016 Health Insurance Rate Development, Filing and Review

Ken Ehresmann and Julia Lerche, Wakely Consulting Group

For the first time, many issuers will have a full year of claims experience upon which to base their ACA rates for 2016.  Though there will continue to be some unknowns, such as the final 2014 risk adjustment transfers and the health status of those who continue to take up insurance, the availability of 2014 claims data will change the way rates are developed and reviewed for 2016.  This webinar explored the considerations for 2016 rate development, filing and review based on a compilation of CMS regulations and guidance as well as insights from Wakely Consulting Group Actuaries.

The webinar examined these and other changes that will impact 2016 rate filings and rate review, including changes announced in the 2016 Notice of Benefit and Payment Parameters, the 2016 Issuer Letter, and QHP and Unified Rate Review templates and instructions. It also included a discussion of the new requirements for Effective Rate Review programs related to public disclosure of rate filings.

The webinar slides can be found at the “download” button and a webinar recording can be found here.


Expert Perspectives

September 6, 2024

Current Considerations for State Reinsurance Programs

Reinsurance is a long-standing tool for stabilizing health insurance markets and reducing premiums, and has played an important role in the success of the Affordable Care Act’s individual market as part of section 1332 state innovation waivers. Reinsurance increases affordability for consumers ineligible for the premium tax credit (PTC). However, the effects on PTC recipients are smaller, mixed, and have received little attention. This expert perspective summarizes recent research which raises questions about the impact of reinsurance programs on PTC recipients, and highlights related considerations for state policymakers.

CMS Issues Guidance on Renewal Timeliness Post-Unwinding

On August 29, 2024, the Centers for Medicare & Medicaid Services (CMS) released a CMCS Informational Bulletin (CIB) and accompanying slide deck to support states facing renewal backlogs. With this guidance, CMS is providing states additional time—until December 31, 2025—to complete Medicaid and CHIP eligibility renewals, address persistent backlogs in processing redeterminations, and achieve compliance with federal renewal timeliness requirements. This expert perspective provides an overview of the CIB.