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Update on Cost Study and Future Rulemaking for Navigators and Essential Health Benefits

This update from the Department of Insurance focuses on the latest developments from CCIIO regarding cost studies, vendor engagement processes, and the provision of reports to DOI and the Working Group. Key areas of focus include state enforcement, essential health benefits, federal support to state-based exchanges (SBE), grant funding for SHOP, and responses to premium shock. There will also be future rulemaking implications including stakeholder engagement timelines and clarification on navigators' licensing requirements. Significant details on market reforms and exchanges remain to be shared.

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Update on Cost Study and Future Rulemaking for Navigators and Essential Health Benefits

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Presentation Transcript

  1. Department of Insurance –Update Cost Study Latest from CCIIO Navigators Future Rulemaking / Guidance

  2. Costs • Process of engaging vendor, to study costs and provide report to DOI and Working Group

  3. CCIIO • State enforcement • Essential Health Benefits • Exchanges • Fed’l Support to SBE • FFE / P’p • Grant funding • SHOP • Response to “premium shock” question • Timeframe stakeholder engagement

  4. Navigators • States cannot require navigators to be licensed as agents or brokers or to have E & O insurance • States taking various approaches • Market / Consumer “Assisters”

  5. Future Rulemaking • 2014 market reforms • Exchanges • EHB

  6. Future Guidance • FFE – lots of detail not yet shared • Exchanges in general • EHB • 3Rs

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