Insurance Exchanges

The ACA includes Small Business Health Options Programs (SHOP) exchanges, intended to provide administrative relief and affordable coverage options to small employers across the country. This paper provides an overview of SHOP exchange development in six states. The six state based exchanges studied are all intending to offer employee choice in 2014 and report an encouraging amount of carrier interest. State contacts note that employer education is one of the major challenges they face, and outreach efforts to small businesses are just beginning.

This paper focuses on states' roles in implementation of FFEs. We start by providing an overview of recent regulations issued by CCIIO that describes the possible roles both for states and the federal government in the FFEs. We then provide in-depth descriptions of each of the specific FFE options as implemented in three states-Alabama, Michigan, and Virginia-with an eye to each state's role in developing mechanisms to carry out their new responsibilities and progress in creating relationships with the federal government in order to ensure successful implementation of the three types of federally facilitated exchanges.

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.

This module’s primary purpose is to act as a pre-requisite training to the enrollment assistance trainings required for Community Partner Employees to become certified Application Assisters by Cover Oregon.

 Access Health CT released a draft of its navigator and in-person assistor training course syllabus.

This paper focuses on states’ roles in implementation of FFEs. It provides an overview of recent regulations issued by CCIIO that describe the possible roles both for states and the federal government in the FFEs. It then provides in-depth descriptions of each of the specific FFE options as implemented in three states—Alabama, Michigan, and Virginia—with an eye to each state’s role in developing mechanisms to carry out their new responsibilities and progress in creating relationships with the federal government in order to ensure successful implementation of the three types of federally facilitated exchanges.

This report outlines the required minimum functions of exchanges, and explains how exchanges are expected to be established and administered under ACA. The coverage offered through exchanges is discussed, and it provides detail on how individuals will qualify for federal tax credits. The report concludes with a discussion of how exchanges will interact with selected other ACA provisions.

This final rule issued by HHS amends existing regulations regarding triggering events and special enrollment periods for qualified employees and their dependents. It also confirms that implementation of employee choice in the federal SHOP exchange will be delayed until 2015. 

The ACA and the Department of Health and Human Services (HHS) regulations require states and American Health Benefit Exchanges (exchanges) to carry out a number of key functions, for which state responsibilities vary by exchange type. Despite some challenges, the seven selected states in GAO’s review reported they have taken actions to create exchanges, which they expect will be ready for enrollment by the deadline of October 1, 2013

One in four consumers who will apply for health coverage through the new health insurance marketplaces speak a language other than English at home. The Affordable Care Act and federal civil rights laws require marketplaces to provide language services for people with limited English proficiency (LEP). It is critical that marketplaces develop robust standards to ensure that these language services enable LEP consumers to successfully enroll in, use, and retain coverage. This checklist provides a list of recommendations that advocates can use to encourage their states to address the needs of LEP consumers in their health insurance marketplace.