1 / 8

Overview of Arizona's Federally Facilitated Marketplace and Insurance Landscape

This report examines the Arizona Marketplace landscape since October 1, 2013, with insights into enrollment figures, premium ranges, and various roles of the Arizona Department of Insurance. Key statistics include the selection of over 27,943 Marketplace plans, additions to AHCCCS, and the spectrum of premium costs for medical plans. The document outlines the responsibilities of the Department in managing exchanges, consumer assistance, and oversight of insurance companies. Essential for understanding Arizona's approach to health insurance in the context of federal regulations.

metta
Télécharger la présentation

Overview of Arizona's Federally Facilitated Marketplace and Insurance Landscape

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Arizona: A Federally Facilitated Marketplace Erin H. Klug, Arizona Department of Insurance

  2. Arizona Marketplace Landscape Since 10/1/2013 • 27,943– Marketplace Plans selected (HHS Enrollment Report October 1, 2013 – December 28, 2013) • 98,203 – Adults added to AHCCCS (1,369 in 100-133% FPL category; AHCCCS Enrollment Update as of 1/10/14) • $144 to $665 – Premium range (Marketplace medical plans, age 30, all counties, all metal levels; https://www.healthcare.gov/shop-health-plan-information/)

  3. FFMcertified insurance companies in AZ:

  4. Who does what in Arizona? CCIIO/CMS State Insurance Department Outreach/education: Direct advertising, consumer publications, funding others Approve and remove entities to operate on the exchange: QHP issuers, agents, web-brokers, Navigators, CACs Management of the exchange website: Collect, correct and display insurer plandata Consumer Assistance Marketplace appeals, special enrollment, APTC & CSR Premium Stabilization: Risk adjustment, reinsurance and risk corridors programs Links to Medicaid/AHCCCS for eligibility determination Regulate contracts of insurance issued by health insurers on- and off-exchange: Review insurance contracts, rates, and advertising for compliance with state requirements and ACA Consumer Assistance Monitoring & Enforcement Financial oversight of insurers

  5. How do we coordinate? • CCIIO certification of QHP issuers requires DOI input on: • Insurer licensure • Insurance policies and rates filed/approved • HMO service areas • Enforcement activity • DOI may require data regarding insurer and agent exchange activity to perform: • Complaint investigations • Market analysis • Fiscal monitoring

  6. How we assist consumers? • FFM assists consumers with: • Plan enrollment and eligibility • Special Enrollment • APTC eligibility • Marketplace appeals • ADOI assists consumers with: • Problems with insurance plans • Claim denials/delays, appeals • Access to care • Agent misconduct • Unlicensed activity/insurance scams

  7. What’s next? • Plan networks • Mismatches • Decertification process • Producers (agents) on the exchange • Fraud

  8. Consumer Affairs DivisionArizona Department of Insurance2910 N. 44th Street, Ste. 210Phoenix, AZ 85018www.azinsurance.gov602.364.2499Erin H. Klug - eklug@azinsurance.gov

More Related