To inform the design and development of the Small Business Health Options Program (SHOP) Exchange, New York retained Wakely Consulting to interview a sampling of the state’s small employers regarding health insurance coverage issues. Employers interviewed included those who do and do not currently offer coverage to their employees.
This report, prepared by Health Management Associates, examines four options for New York’s Medicaid benchmark plan selection. Under the Affordable Care Act (ACA), states are permitted to define the benefits package for a newly mandatory category of non-elderly, non-disabled adults. In New York, most of these adults are already eligible for public coverage – including 1.1 million adults enrolled in Medicaid or Family Health Plus.
This report, prepared by Deloitte, provides an overview of the impact of health reform on the Healthy New York (HNY) and Family Health Plus-Employer Buy-In (FHP-EBI) programs. Both programs were designed to provide health insurance coverage to segments of the population at risk for going uninsured - low to moderate income individuals and small businesses - and overlap significantly with populations that will be eligible for subsidized coverage under federal reform.
KPMG conducted an analysis to assess the needs of employers, producers, insurers, employees and the Small Business Health Options (SHOP) Exchange to assist in planning for the design, implementation, and operation of a successful SHOP Exchange in New York State.
This study, prepared by Health Management Associates (HMA), describes the current state of New York’s individual and small group insurance markets, including the market concentration of insurers, geographic distribution of enrollment, cost sharing and actuarial value of plans offered, and the distribution channels for accessing insurance in these markets.
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.
This report describes the small group products available in New York today, how these products align to the requirements of the ACA, and presents options for consideration to standardize products within the Exchange.
This report provides recommendations for New York's approach to addressing the ACA's risk adjustment and reinsurance requirements and implementing these programs. Risk adjustment is the method of adjusting premium rates for differences in underlying morbidity of a health plan's membership. Reinsurance describes methods for protecting health plans against high cost individuals.
This report explores the critical interactions that third party assistors have with buyers and sellers of insurance in the New York market and presents various models for incorporating and compensating producers and other intermediaries in the New York Health Benefit Exchange.
This memo summarizes the effects of the Patient Protection and Affordable Care Act of 2010 (ACA) on state Medicaid spending in New York. The estimates in this memo are based upon results from a complete simulation using the Urban Institute’s Health Insurance Policy Simulation Model, New York Version (HIPSM -NY) and are intended to provide analytic support to the state’s policymakers.