Aca 2014 beyond
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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

ACA2014 & Beyond

Rhonda Fossitt

Senior Deputy Director


Aca 2014 michigan successes

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

ACA: Key Decisions

  • Transitional Policy: Nov. 2013

  • Extended Transitional Policy: April 2014

  • SHOP (Small Business Health Options Program) Employee Choice: June 2014


Aca 2015 challenges

ACA: 2015 Challenges

  • Short timeline to prepare & approve QHP filings

  • Pricing

  • Late guidance

  • Redetermination and renewals


2015 perspective a game of survivor

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


Updates for 2015

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


Deadlines for 2015

Deadlines for 2015


Plan benefit template report from d ifs

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


Preview of the issues 2016 and beyond

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

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


What does happy mean to difs health plans staff

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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