ACA 2014 & Beyond Rhonda Fossitt Senior Deputy Director.

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Presentation transcript:

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 Transitional Policy: Nov Extended Transitional Policy: April 2014 SHOP (Small Business Health Options Program) Employee Choice: June 2014

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

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

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

Deadlines for 2015 QHP Application Submission and Review Process Michigan Filing Deadline06/09/2014 Plan ID Crosswalk Template08/04/2014 DIFS Transfers Plan Data to CMS08/08/2014 CMS Reviews Plan Data08/11/2014 to 08/25/2014 CMS Notifies DIFS of Necessary Corrections to QHP Data 08/26/2014 Final Deadline for Issuers to Resubmit Data Into SERFF 09/04/2014 DIFS Transfers Revisions to CMS09/05/2014 to 09/10/2014 CMS Completes Re-Review of Plan Data and State Recommendations 09/22/2014 Limited Window for Plan Correction09/24/2014 to 10/06/2014 QHPCertification Notices and QHP 10/14/2014 Agreement/FinalAgreements Sent to Issuers, CertificationAgreements Signed, QHP Data FinalizedTo 11/03/2014 Open Enrollment11/15/2014

Plan & Benefit Template – Report from D IFS 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

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

Resources that DIFS Provides to 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

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