Tag Archive: Oregon

Vermont mulls working with nearby states on health benefit exchange enrollment, call center

Lt. Gov. Phil Scott, senators explore alternative to Vermont Health Exchange – VTDigger.

The VTDigger reports Vermont officials are considering partnering with adjacent states or sharing vendor resources for its health benefit exchange eligibility and enrollment and call center functions as an alternative to partnering with the federal government to support its state-based exchange as have Oregon, Nevada and New Mexico.

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

Federal government liberalizes ACA definition of QHP to boost enrollment in troubled state exchanges

The U.S. Department of Health and Human Services’ Center for Consumer Information & Insurance Oversight issued guidance (.pdf) this week aimed at boosting enrollments in six state health benefit exchange marketplaces hobbled by glitches in their online enrollment web portals. The guidance issued February 27, 2014 allows the marketplaces to deem individuals eligible for retroactive coverage back to January 1, 2014 if they meet eligibility requirements but were unable to enroll in a plan by the upcoming March 31 plan year 2014 enrollment deadline due to the technical problems with the portals – described as an “exceptional circumstance” in the guidance.

The federal guidance uses the exceptional circumstance declaration to get around the definition of a qualified health plan (QHP) at Section 1301 of the Patient Protection and Affordable Care Act as one certified by an exchange exclusively for sale on the exchange marketplace. The guidance does so by including those who enrolled in non-QHPs – plans sold outside the exchange marketplace. Those enrollees would then be potentially eligible for subsidies in the form of advance premium tax credits and cost sharing reductions that would not otherwise be available to them. According to The New York Times, Oregon Gov. John Kitzhaber requested the federal government to allow the premium tax credits for people buying insurance outside that state’s troubled exchange.

This limited relief from the March 31 deadline for plan year 2014 enrollment and the extension of premium tax credit and cost sharing subsidies to non-QHPs will take pressure off the six troubled state exchange marketplaces that due to enrollment shortfalls may be unable to support themselves financially starting in 2015 when federal establishment grant assistance ceases as required by the Affordable Care Act. For more on this, click here.

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

Maryland mulls high risk pool fallback for individuals with exchange enrollment problems

Maryland Health Exchange Emergency Bill to be Submitted Next Week « CBS DC.

The proposed legislation would enable individuals seeking coverage through the Maryland’s health benefit exchange but whose enrollments encountered processing glitches to obtain coverage through the state’s high risk pool. According to the story, the coverage would be retroactive to January 1, 2014, when state high risk pools were to end operations under new Patient Protection and Affordable Care Act market rules barring medical underwriting for individual health plans effective that date or later.

Several other states operating their own health benefit exchanges that experienced severe problems with the launch of their web portals face a similar predicament as Maryland including Hawaii, Oregon, Minnesota, Vermont and Massachusetts.

The account also quotes Maryland Gov. Martin O’Malley as stating Maryland is considering the possibility of switching from a state-based to federal exchange either completely or in part, as well as partnering with other states.

Section 1311(f) of the Affordable Care Act authorizes the operation of “Regional or Other Interstate Exchanges” operating in more than one state, subject to the approval of the involved states and the federal Department of Health and Human Services.

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

Dozen health plan issuers to participate in marketplace, Oregon health benefit exchange announces

Oregon’s health benefit exchange, Cover Oregon, announced today that 12 health insurance plan issuers have filed plans to sell on its marketplace opening this fall for 2014 pre-enrollment.  Ten are commercial carriers and two are nonprofit Consumer Operated and Oriented Plans as authorized by Section 1322 of the Patient Protection and Affordable Care Act.  Below are the carriers listed in Cover Oregon’s news release:

Individual Market Carriers in Cover Oregon

  • ATRIO Health Plans
  • BridgeSpan Health Company
  • Oregon’s Health CO-OP
  • FamilyCare Health Plans
  • Freelancer’s CO-OP
  • Health Net
  • Kaiser Permanente
  • LifeWise Health Plan of Oregon
  • MODA (ODS)
  • PacificSource Health Plans
  • Providence Health Plans
  • Trillium Community Health Plan

Small Employer Market Carriers in Cover Oregon

  • ATRIO Health Plans
  • Oregon’s Health CO-OP
  • Freelancer’s CO-OP
  • Kaiser Permanente
  • MODA (ODS)
  • PacificSource Health Plans
  • Providence Health Plans
  • Trillium Community Health Plans
 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

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