HHS Major Announcement Coming on Monday

[STIBROKER]

Stay the he'll out of texas

man....guess I better start working on my " health insurance exchange texas" page.................

 

[Dave020]

Here is some of the 'stuff' from the CA exchange upcoming:

Inside the Exchange

In each California region, the exchange is to provide a choice of QHPs at each of the five federally specified coverage levels (four "precious metals" plus catastrophic). [GC §100503(d) perAB 1602 §7] ​

Participating carriers are to "fairly and affirmatively" offer at least one product in each of the five levels. [GC §100503(e), HSC §1366.6(b), Ins. Code §10112.3(b), per AB 1602 §§7,15,16] ​

Exchange may require participating carriers to offer additional products in each of the five levels. [GC §100503(e), HSC §1366.6(b), Ins. Code §10112.3(b), per AB 1602 §§7,15,16] ​

And now for the real fun...............................

In the Outside Market

Effective January 1, 2014, carriers may only sell products that conform to the five federally specified coverage levels (four "precious metals" plus catastrophic). [HSC §1366.6(d), Ins. Code §10112.3(d), per AB 1602 §§15,16] ​

Carriers that do not participate in the exchange may not sell products in the catastrophic coverage level. [HSC §1366.6(d), Ins. Code §10112.3(d), per AB 1602 §§15,16] ​

If the exchange designates standardized products inside the exchange, carriers that do not participate in the exchange must nevertheless offer at least one exchange-designated standardized product in each of the four "precious metal" levels (but not the catastrophic level). [HSC §1366.6(e), Ins. Code §10112.3(e), per AB 1602 §§7,15,16] ​

So, in California carriers can only sell Gold, Silver, Platinum, Bronze and Catastrophic plans inside AND outside of the exchange. And if a carrier won't sell inside the exchange, they can still only sell a "metal" plan and are barred from selling the Cat plan.

And let's not forget "outreach and marketing"............

The exchange is to establish a "navigator" program. [GC §100502(l) per AB 1602 §6] ​

The exchange is to select and set performance standards and compensation for navigators. [GC §100503(l) per AB 1602 §7] ​

Open Issue:

Unclear where "start-up" funds for navigators might come from before the exchange becomes operational.​

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[pahealthquotes]

^^ thanks for the cliff notes. you know the more I read the more confusion sets in. I dont think we'll really know whats going to happen and how everything will work until mid 2014. This is one giant mess.

 

[Dave020]

^^ thanks for the cliff notes. you know the more I read the more confusion sets in. I dont think we'll really know whats going to happen and how everything will work until mid 2014. This is one giant mess.

I agree. And remember, even if this goes into effect as written, by 2014 any number of changes can and likely will occur. We may well see a PPACA much different than was written in 2010. I plan to keep on until I am told I can't sell it anymore.

But as Chumps says, "Get out now, don't wait, start today"