2016 & Beyond Rhonda Fossitt Senior Deputy Director July 17, 2015.

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Presentation transcript:

2016 & Beyond Rhonda Fossitt Senior Deputy Director July 17, 2015

ACA: 2016 Highlights – Year 3 Number of Issuers & Plans by Market Employee Choice on the SHOP

Small Group On/Off Market 7 Issuers 337 Plans Small Group Off Market 15 Issuers 434 Plans Individual On/Off Market 15 Issuers 227 Plans Individual On/Off Market 15 Issuers 227 Plans Individual Off Market 6 Issuers 29 Plans Individual Off Market 6 Issuers 29 Plans 2016 Number of Issuers & Plans by Market

Individual On/Off Market 15 Issuers 227 Plans Individual On/Off Market 15 Issuers 227 Plans 2016 Individual – On/Off Market

Individual On/Off Market 1 Issuer 1 Issuer 11 Plans 11 PlansIndividual On/Off Market 1 Issuer 1 Issuer 11 Plans 11 Plans Change Since 2015

Individual Off Market 6 Issuers 29 Plans Individual Off Market 6 Issuers 29 Plans 2016 Individual – Off Market

Individual Off Market 1 Issuer 1 Issuer 125 Plans 125 PlansIndividual Off Market 1 Issuer 1 Issuer 125 Plans 125 Plans Change Since 2015

2016 Small Group – On/Off Market Small Group On/Off Market 7 Issuers 337 Plans

Change Since 2015 Small Group On/Off Market 4 Issuers 4 Issuers 53 Plans 53 Plans

2016 Small Group – Off Market Small Group Off Market 15 Issuers 434 Plans

Change Since 2015 Small Group Off Market No Change In Issuers 292 Plans 292 Plans

2016 Employee Choice for the SHOP Originally scheduled for 2015 Michigan opted to delay Employee Choice -Employers may allow employees:  to choose any health plan at metal level selected by employer

ACA: 2016 Timeline Reminders ActivityDates Company-wide Participation in Plan Preview Contact DIFS if Errors Found (NEW!) 7/17/2015 to 8/5/2015 Date to Review & Contact DIFS on Plan Preview (NEW!)8/5/2015 CMS Notifies DIFS/Issuers of Necessary Corrections to QHP Data 8/13/2015 to 8/14/2015 Final Deadline for Issuers to Resubmit Data to DIFS 8/20/2015 Begin Marketing or Pre-Enrollment On or Off Marketplace *Date QHP Agreements are Finalized with CMS (Approx. 10/9/2015) *Applies even if you are not required to sign QHP Agreement

ACA: 2016 Significant Issues – Year 3 Expansion of Small Group Large Group Transitional Policy

Expansion of Small Group Market Under ACA Effective January 1, 2016 Definition of “small employer” will change -Employers with 100 of few FTE employees -Previously 50 or fewer

Expansion of Small Group Market Under ACA According to American Academy of Actuaries: Number of employees covered under small group market may increase by 30% Groups sized will have more restrictive rating rules Groups sized will have more benefit and cost-sharing requirements Could result in more self-insurance

Keep Current Definition of Small Group Legislation introduced in Congress to keep current definition of small group With King v Burwell behind us, legislation may move forward Legislation supported by many groups If law is enacted, timing will be important

Large Group Transitional Policy Michigan has adapted the Large Group Transitional Policy Allows small employers (51-100) Renewing prior to 10/1/2016 To delay adapting the small group definition Transitional policies may not remain in effect beyond 10/1/2017

ACA: DIFS Selected a Benchmark Plan for 2017 As per HHS guidance, DIFS compared 10 plans in-force 3/31/2014: 3 Largest Small Group Plans 3 Largest State Employee Plans 3 Largest Federal Employee Plans Largest HMO Plan

ACA: DIFS Selected a Benchmark Plan for 2017 DIFS: Prepared comparison chart of 10 plans, along with Benchmark Plan for Dental and Vision Posted for public comment – May 15 to June 5 Reviewed public comment

Priority Health HMO Selected as Michigan Benchmark Plan Selection Based on: Mitigating rate increases for Michigan consumers Ensuring all EHB requirements are met Substantially similar to the current EHB benchmark plan The 2017 Essential Health Benefits Benchmark Plan Executive Report is posted on the DIFS website. This report outlines the process and selection of the plan.Report

Michigan Benchmark Plan – Final Steps CMS will: Post for public comment in late summer Post the approved version in the Fall of 2015