Information on the Mechanics of Exchanges

[insurehound]

So I am trying to find a "one-stop" place where I can learn all about how HCR will work within both the SHOP and Individual Exchanges. Being in California, I have been reading a lot in on the California Health Benefit Advisors website.

Covered California Health Benefit Exchange, CAHBA

Any other suggestions? I also have recaps of many of the "Covered California" Board meetings.

Thanks!

 

[AllenChicago]

Insurehound, fortunately (I think?) you're in one of the few cutting edge states when it comes to exchange development. Aside from California, Utah is building theirs pretty quickly. A lot of it is under construction, but you can bookmark the URL for reference if you want to. It's: Utah Health Exchange .

Also, Queen Sebelius at HHS announced this morning at some pep rally that they've redesigned the healthcare.gov site to provide more information on exchanges, tax credits, penalties, etc.. Since HHS hasn't made many meaningful decisions yet, the revamped website is a work in progress. But at least the info that gets posted will be coming directly from the horse's mouth.

Link: Health Insurance Marketplace | HealthCare.gov

My greatest curiosity is to see the prices/plan designs as the various states exchanges start to come online later this Summer.

-Allen

p.s. Looking over the California Health Exchange website, I see that Navigators will be paid $58.00 per enrollment, but that "individuals" can't be Navigators. However, UNIONS can be. They'll reap a financial windfall strong-arming members into the exchange!...LOL.

 

[Yagents]

What I found interesting or a confirmation on that HHS site:

1. They are calling it a "marketplace" vs health exchange

2. They don't like agents or commissions:

If you're having difficulty finding a plan that meets your needs and budget, there'll be people available to give you personalized help with your choices. These helpers aren't associated with any particular plan, and they aren't on any type of commission, so the help they give you will be completely unbiased.

3. You can control how much of the tax credit you want if you expect higher income:

you can control how much of your tax credit you want to use to help pay your monthly health plan premiums.

4. They mention the "clawback"

If the amount of income you report isn't accurate, you may not get the right amount of tax credit you're eligible for, and it could mean you have to pay back money at the end of the year.

5. They pay the insurance company directly

The tax credit is sent directly to your insurance company and applied to your premium, so you pay less out of your own pocket.

 

[taterpeeler]

Look bill....we have the same thing now with mapd and how they try and sign em up without us.... That will effect a few just like it does now with Medicare... We should be fine... The bottom line still for me is what are you gonna pay us... If the number works we will work... If it doesn't then they can kiss my rear and I will just do Medicare and they can enjoy signing people up.... It's all fairly simple

 

[AllenChicago]

Want a good laugh? Check out this page at the official State of Illinois Healthcare reform website:
Health Care Reform : Illinois Data

It's crazy that the US Government sent Illinois $15,000,000 of US taxpayers money to "fight unreasonable premium increases"! Illinois can't deny a premium increase, so what fighting can they do? Maybe use the $15 million to bribe CEO's not to raise rates quite as much?

-ac

 

[Yagents]

UnitedHealth to be a tough exchange player | LifeHealthPro

 

[insurehound]

Speaking of UHC...

Conflict-of-interest concerns raised as Obama races to implement health reform - The Hill's Healthwatch

 

[Yagents]

Crazy stuff.....$1.5 BILLION handed out to about 8 states for the next installment for their exchange. $650 million to california alone. What kind of system would cost that much? Not one cent goes to health care costs to the citizens... waste at it's best.