The clock is ticking as states await the federal calculator. Some states have already delayed initiating their processes, which include meeting with their states’ health insurance marketplace boards to review the standards for plans to be offered through their marketplaces in 2020. This will create duplicative work and added costs as states resolve changes with their regulators, insurers, and for some – marketplace boards. Some states may opt to use last year’s calculator in the interim, but if HHS changes the calculator, states will need to reconcile those changes to comply with federal law.
#EASTERN SOUTH CAROLINA COMMUNITY HEALTH CALCULATOR FULL#
Without the 2020 calculator, states will be forced to make decisions about the parameters the updated calculator will set for their health plans without full knowledge of the “rules of the road” for next year. In some states, health plan rate reviews and their timelines are set by state law, giving them little flexibility to adapt to federal delays. In previous years, the calculator has only made mild adjustments to the federal AV each year, but even small changes can impact to state markets - changing how plans are categorized for consumers and altering assessment of tax credits and cost-sharing reductions available to them. State insurance regulators are required to evaluate benefit design, cost-sharing, and other critical elements of the plans that will be offered in 2020 using the federal AV standards. Many states’ premium rate filing deadlines are approaching in April, creating an urgency for state regulators and insurers who need to make sure the plans they propose meet federal standards, which have not yet been released.įederal law requires insurers to use the AV calculator to assess the “value” of the plans they will offer through individual or small group markets. Parameters for the AV calculator are defined in the Annual Notice of Benefit and Payment Parameters rule issued by the US Department of Health and Human Services (HHS), which typically is released between October and December. These metal tier designations are significant, both because they help give consumers some indication of the worth of the coverage they purchase and tax credits used to subsidize coverage are based on the second-lowest cost plan with a Silver designation sold in the state (known as the benchmark plan). Chronic Disease Prevention and ManagementĪV is used to sort plans into metal tiers - from Platinum (90 percent AV) to Bronze (60 percent AV).Primary Care/Patient-Centered/Health Home.Integrated for Pregnant/Parenting Women.Healthy Child Development State Resource Center.
Physical and Behavioral Health Integration.The RAISE Family Caregiver Resource and Dissemination Center.Children and Youth with Special Health Care Needs.
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