Insurance Reforms
The ACA establishes a series of insurance reforms. ACHP has complied regulations, summaries, and reports on these reforms
Transitional Reinsurance and High Risk Pool
Risk Adjustment, Risk Corridors, and Reinsurance
Grandfathered Health Plans - Interim Final Rule
The Departments of Labor and Health and Human Services released an interim final rule on Grandfathered Plans. ACHP's comment letter can be found here.
June 2010
Grandfathered Health Plans - Interim Final Rule Amendment
The Departments of Labor and Health and Human Services released an amendment to the interim final rule on Grandfathered Plans. The amendment addresses concerns regarding loss of grandfathered status.
November 2010
Grandfathered Health Plans - HPA Summary of the IFR
Health Policy Alternatives, Inc., provided a summary of the grandfathered plan interim final rule.
June 2010
Health Affairs - Policy Brief on Grandfathered Plans
Health Affairs has prepared a brief on grandfathered plans including background information and a regulatory summary
October 2010
Coverage of Dependent Children to Age 26
NAIC - Model Language for Dependent Coverage to Age 26
The Health Insurance and Managed Care (B) Committee and Plenary adopted model language for Dependent Coverage to Age 26.
December 2010
Coverage to Age 26-Interim Final Rule
The Department of Health and Human Services issued the interim final rule for the ACA's provision requiring insurers to cover dependent children until their 26th birthday. The interim final rule became effective July 12.
May 2010
Coverage to Age 26 - White House Recognition for Early Implementation
The White House recognized early implementation efforts of ACHP member organizations. ACHP's early implementation letter can be found here.
April 2010
Coverage to Age 26 - HPA Summary
Health Policy Alternatives, Inc., prepared a summary of the dependent coverage interim final rule.
May 2010
Coverage to Age 26 - CRS Report on Dependent Coverage
The Congressional Research Service provided a report on PPACA's dependent coverage provision.
July 2010
Medical Loss Ratio - Final Rule
The Center for Consumer Information and Insurance Oversight (CCIIO) released the final rule on Medical Loss Ratio. CCIIO prepared a fact sheet on the final rule that can be found here. The rule is effective January 1, 2012. ACHP's comment letter on the interim final rule can be found here, and the interim final rule can be found here.
December 2011
Medical Loss Ratio - Summary of 2010 Data Submitted to NAIC
September 13, 2011
Medical Loss Ratio - Summary of Interim Final Rule
Health Policy Alternatives, Inc., prepared a summary of the Secretary's Medical Loss Ratio Interim Final Rule.
November 2010
Medical Loss Ratio - Request for Comment
The Department of Health and Human Services issued a request for comment on implementation of PPACA provisions on the reporting of medical loss ratio and payment of rebates.
April 2010
Medical Loss Ratio - ACHP Response to the Request for Comment
ACHP prepared this response to the Secretary’s request for comment on medical loss ratio.
April 2010
Medical Loss Ratio - Congressional Intent Letter
The Chairs of the House Ways and Means, Energy and Commerce, and Education and Labor Committees and the Chairs of the Senate Finance, H.E.L.P., and Banking Committees sent a letter to Secretary Sebelius and The NAIC expressing their legislative intent on taxes associated with Community Benefits.
August 2010
Premium Rate Review - Final Rule
The Department of Health and Human Services has released the final rule for premium rate review. The final rule contains a few changes, but does make the rule effective September 1, 2011.
May 2011
Premium Rate Review - Commonwealth Fund Brief
The Commonwealth Fund has prepared a brief summary of key points in the premium rate review final rule including threshold, determining an excessive rate increase, reporting and disclosure, and determining which states have an effective review process.
Premium Rate Review - Health Affairs Issue Brief
Health Affairs has prepared an issue brief on the ACA's unreasonable insurance rate increase provision and summary of the proposed rule.
March 2011
Premium Rate Review - Notice of Proposed Rule Making
Secretary Sebelius issued a request for comment on PPACA's premium rate review provision. ACHP's comment letter can be found here.
December 2011
Premium Rate Review - HPA Summary
Health Policy Alternatives, Inc., prepared a summary of the Premium Rate Review Interim Final Rule.
January 2011
Kaiser Family Foundation - Rate Review Issue Brief
The Kaiser Family Foundation has prepared an issue brief outlining PPACA's premium rate review provision
December 2010
Premium Rate Review - Request for Comment
The Department of Health and Human Services issued a request for comment on implementation of PPACA provisions on the reporting of premium rate review.
April 2010
Transitional Reinsurance and High Risk Pool
Preexisting Condition Insurance Plan Policy Brief
Health Affairs and The Robert Wood Johnson Foundation have prepared a policy brief on the preexisting insurance plan in effect until 2014.
July 2011
Preexisting Conditions Insurance Plan (Temporary High Risk Pool) - Interim Final Rule
The Department of Health and Human Services published the interim final rule for the preexisting conditions insurance plan (temporary high risk pool) in the Federal Register. The rule became effective July 30.
July 2010
Insurance reforms - CRS Report on preexisting conditions exclusions
The Congressional Research Service provided a report on PPACA's preexisting health conditions exclusions provision.
July 2010
Preexisting Conditions Insurance Plan (Temporary High Risk Pool) - HPA Summary of IFR
Health Policy Alternatives, Inc., prepared a summary of the interim final rule for preexisting conditions insurance plan (temporary high risk pool).
August 2010
Temporary High Risk Pools - CBO Letter
The Congressional Budget Office provided an analysis of newly created federal high-risk pools.
June 2010
Retiree Reinsurance - Administration Fact Sheet
The Administration has published a fact sheet on PPACA's retiree reinsurance program.
June 2010
Retiree Reinsurance - Interim Final Rule
The Department of Health and Human Services is required to establish a reinsurance program for early retirees’ ages 55-64 who incur high health care costs.
May 2010
Insurance Reforms Effective September 23, 2010
CRS - Temporary Federal High Risk Health Insurance Pool Program
The Congressional Research Service has prepared an analysis of the ACA's temporary federal high risk insurance program.
April 2011
Commonwealth Fund - Report on Cost-Sharing and Disclosure Requirements
The Commonwealth Fund has published a report on the potential effects of PPACA's disclosure requirement. The summary can be found here.
February 2011
NAIC - Model Preexisting Exclusion Prohibition
The Health Insurance and Managed Care (B) Committee and Plenary adopted model language for prohibiting preexisting conditions exclusions for individuals under 19 years of age.
December 2010
NAIC - Model Language for Prohibition of Rescissions of Coverage
The Health Insurance and Managed Care (B) Committee and Plenary adopted model language for the PPACA provision prohibiting rescission of coverage.
December 2010
Davis & Harmon - PPACA Non Discrimination Review Presentation and Narrative
The firm of Davis & Harmon has prepared a presentation and narrative analysis of the non-discrimination provision in the health insurance reform section of PPACA.
October 2010
NAIC - Model Language for Prohibition of Lifetime and Annual Limits
The Health Insurance and Managed Care (B) Committee and Plenary adopted model language for the prohibition of lifetime and annual limits.
December 2010
Insurance reforms - Interim Final Rule
The Departments of Treasury, Labor, and Health and Human Services published an interim final rule on preexisting health conditions exclusions, lifetime and annual coverage limits, and rescissions.
June 2010
Insurance reforms - HPA Summary of the IFR
Health Policy Alternatives, Inc., prepared a summary of the interim final rule on preexisting health conditions exclusions, lifetime and annual coverage limits, and rescissions.
June 2010
NAIC - Model Language for Carrier Grievance Procedure
The Health Insurance and Managed Care (B) Committee and Plenary adopted model language for appeal and review of adverse claims determination.
December 2010
Internal Claims and Appeals and External Review - Interim Final Rule
The Departments of Treasury, Labor, and Health and Human Services published the interim final rule for internal claims and appeals and external review. The rule is effective September 21, 2010 and comments are due no later than September 21.
July 2010
Internal Claims and Appeals and External Review - HPA Summary of IFR
Health Policy Alternatives, Inc., prepared a summary of the claims and appeals and external review interim final rule.
August 2010
Secretary Sebelius leads efforts to improve access to coverage for children with pre-existing conditions, urges states to take action
Maryland has entered into an agreement with Kaiser Mid-Atlantic to establish a children open-enrollment period, eliminating the need for child only plans.
October 2010
Proposed Rule - Risk Adjustment, Risk Corridors, and Reinsurance
The Department of Health and Human Services published a proposed rule implementing the risk adjustment, risk corridors, and reinsurance provisions of the ACA. Comments are due on October 31.
July 2011
Health Policy Alternatives - Summary of Risk Adjustment, Risk Corridors, and Reinsurance NPRM
Health Policy Alternatives, Inc., prepared a summary of the risk adjustment, risk corridor, and reinsurance proposed rule.
July 2011
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