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ACA 2014 & Beyond

ACA 2014 & Beyond. Rhonda Fossitt Senior Deputy Director. ACA: 2014 Michigan Successes. 272,539 Michiganders enrolled in Marketplace plans 13 Health Companies Participated in Marketplaces Federal/State partnership protects Michigan companies and consumers. ACA: Key Decisions.

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ACA 2014 & Beyond

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  1. ACA2014 & Beyond Rhonda Fossitt Senior Deputy Director

  2. ACA: 2014 Michigan Successes • 272,539 Michiganders enrolled in Marketplace plans • 13 Health Companies Participated in Marketplaces • Federal/State partnership protects Michigan companies and consumers

  3. ACA: Key Decisions • Transitional Policy: Nov. 2013 • Extended Transitional Policy: April 2014 • SHOP (Small Business Health Options Program) Employee Choice: June 2014

  4. ACA: 2015 Challenges • Short timeline to prepare & approve QHP filings • Pricing • Late guidance • Redetermination and renewals

  5. 2015 Perspective: A Game of Survivor Turn-over of HHS Staff Late Release of Review Tools Transitional Policy Decisions High Workload Due to Participation Template Challenges Employee Choice in SHOP Decision Redetermination and Renewals Interpreting Late HHS Rules

  6. Updates for 2015 • 18 Health Insurers file for participation on the Marketplace • Increase from 13 Health Insurers in 2014 • Competition fostered by effective & efficient regulatory environment • “2015 Marketplace Plan & Rate Information” added to DIFS website to provide: • Rate Change Requests & Public Comments • Dental Information • Map of Rating Areas • SERFF Portal: Health Rates & Forms Filings

  7. Deadlines for 2015

  8. Plan & Benefit Template – Report from DIFS • In Year 2 • actuarial value stayed fairly constant • catastrophic plans understood • out-of-pocket max understood • Positive Feedback • 25% of companies used data integrity tools & review tools • most companies timely provided complete answers in objection responses • Ways to reduce errors & objections • use data integrity & review tools • check Plan & Benefit Template to be sure it matches forms

  9. Preview of the Issues: 2016 and Beyond • 1/1/2016: Definition of Small Group will increase from 50 to 100 members • 1/1/2016: Essential Health Benefits will be redefined - criteria unknown • 1/1/2017: State decision on whether we would add large group to the SHOP

  10. Resources that DIFS Providesto Health Insurers • Bulletins • Industry Q & A Sessions • Monthly MAHP Meetings • These questions are added to FAQs on DIFS’ website • FAQs on DIFS’ website • Affordable Care Act - 11 Categories • SERFF - State Messages • Conference Calls

  11. What Does HAPPY mean to DIFS Health Plans Staff? • A successful transmittal of a Binder through SERFF to HHS • The message that comes back indicates “HAPI” • We have gone with this theme

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