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Plan Standardization in the Commonwealth Health Insurance Connector

Plan Standardization in the Commonwealth Health Insurance Connector . Anya Rader Wallack, Ph.D. June 6, 2011. CommChoice Seal of Approval Requirements. Participate in all CommChoice offerings (individual, small group, young adult)

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Plan Standardization in the Commonwealth Health Insurance Connector

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  1. Plan Standardization in the Commonwealth Health Insurance Connector Anya Rader Wallack, Ph.D. June 6, 2011

  2. CommChoice Seal of Approval Requirements • Participate in all CommChoice offerings (individual, small group, young adult) • Offer all standardized benefit packages for all plan benefit levels (gold, silver, bronze) • Offer products with the broadest possible provider network available to the carrier (also allowed to offer select/limited network products) • Offer products that provide “good value” with comprehensive benefits

  3. Evolution of offerings in CommChoice (unsubsidized coverage)

  4. Why the changes? • Actuarial equivalency confusing to consumers • Focus groups showed support for simpler (more intuitive) product comparisons • But carriers wanted more flexibility to differentiate • More recent focus groups supported some limited additional flexibility • Beginning July 1, plans can vary cost-sharing for some categories of services

  5. Evolution of offerings in CommCare (subsidized coverage) • Highly standardized plans • Some effort to reduce variation (smoking cessation) • Plans mostly Medicaid-based, restrictions tend to rely more on network and less on benefit design

  6. Issues • On what basis do you want plans to differentiate? • Benefit design • Network • Are employers and consumers best served by more benefit standardization or less? Is the answer different for different market segments?

  7. Current product offerings in RI (non-group, BCBSRI)

  8. Current product offerings in RI (small group, BCBSRI)

  9. Current product offerings in RI (small group, United Health Care)

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