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Oct 17, 2014
Using Your Insurance

Now that you’ve enrolled in a health plan through NY State of Health, you may have some questions about how to use your health plan coverage. Here are some resources with answers to the questions you may have:

Resource Type: 
Materials (English)
Dec 21, 2012
NYS Comments: On HHS Notice of Benefit and Payment Parameters for 2014

On December 7, 2012, the U.S. Department of Health and Human Services (HHS) issued a proposed rule on benefit and payment parameters for 2014. This proposed rule provides further detail and parameters related to: the risk adjustment, reinsurance, and risk corridors programs; cost-sharing reductions; user fees for a Federally facilitated Exchange; advance payments of the premium tax credit; a Federally facilitated Small Business Health Option Program; and the medical loss ratio program. Comments were due by December 31, 2012.
 

Resource Type: 
Policies
Dec 21, 2012
NYS Comments: On Request for Information Regarding Health Care Quality for Exchanges

On November 27, 2012, the U.S. Department of Health and Human Services (HHS) issued a request for information to seek public comments regarding health plan quality management in Exchanges. Comments were due by December 27, 2012.

Resource Type: 
Policies
Dec 21, 2012
NYS Comments: On Health Insurance Market Rules; Rate Review Proposed Rule

On November 26, 2012, the U.S. Department of Health and Human Services issued a proposed rule on health insurance market rules and rate review. This proposed rule would implement the Affordable Care Act’s (ACA) policies related to fair health insurance premiums, guaranteed availability, guaranteed renewability, risk pools, and catastrophic plans. The proposed rule would clarify the approach used to enforce the applicable requirements of the ACA with respect to health insurance issuers and group health plans that are non-federal governmental plans.

Resource Type: 
Policies
Dec 21, 2012
NYS Comments: On Proposed State Essential Health Benefits Benchmark Plans

In the Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation Proposed Rule (“EHB Rule”) published on November 26, 2012, HHS proposed to define EHB based on state-specific benchmark plans.  The EHB Rule requests public comment on proposed state EHB-benchmark plans.  To aid commenters with their review, HHS provided additional information for each proposed EHB-benchmark plan, including a list of state-required benefits.

Resource Type: 
Policies
Dec 21, 2012
NYS Comments: On Standards Related to EHB, Actuarial Value, and Accreditation Proposed Rule

On November 26, 2012, the U.S. Department of Health and Human Services issued a proposed rule on standards related to essential health benefits, actuarial value, and accreditation. This proposed rule outlines Exchange and issuer standards related to coverage of essential health benefits and actuarial value.

Resource Type: 
Policies
Oct 26, 2012
Blueprint Application

On October 26, 2012, New York submitted its Blueprint application to HHS for approval to operate a state-based health benefit exchange.

Resource Type: 
Policies
Sep 25, 2012
Design Review Documents

The NYS Health Benefit Exchange submitted a series of documents to HHS in advance of the state's in-person design review scheduled for October 9th and 10th in Bethesda, MD.  The sections covered during the design review correspond with requirements of the State's Exchange Blueprint Application for Exchange Certification due November 16, 2012. A copy of the Blueprint application can be found here.

Resource Type: 
Policies
Sep 24, 2012
Essential Health Benefits for the New York Health Benefits Exchange

This report was prepared by Milliman, Inc.  This report identifies the issues around the selection of the essential health benefits (EHB) benchmark and discusses the implications that the EHB choice will have on consumers, businesses, and the state. The report examines the implications of the EHB choice on mandated benefits and the policies offered to the individual and small group markets both in and out of the exchange.

Resource Type: 
Reports & Research
Sep 19, 2012
Glossary of Health Insurance Terms

It is important to understand how health insurance works.  Definitions of key health insurance and health care terms such as co-payment, deductible and coinsurance can be found in this glossary.

Resource Type: 
Materials (English)
Aug 23, 2012
June 2012 Exchange Establishment Grant

On June 28, 2012, New York submitted a Level One application for the federal Exchange Establishment grant. The State received an award of $95.5 million for this grant on August 23, 2012.  New York received a supplemental award of $19 million for this grant on September 20, 2013.

Resource Type: 
Grants

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