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:
Among the policy decisions facing New York is whether and to what extent Health Savings Accounts (HSAs) should be offered through the Health Benefit Exchange. HSAs are savings accounts established by individuals and employers and used to pay for qualified health care costs.
Health disparities are differences between populations in rates of disease, health outcomes, and access to quality care. The Affordable Care Act takes several steps to reduce health disparities, including the creation of health benefit Exchanges to increase access to high-quality insurance. In September 2012, the New York Health Benefit Exchange convened a stakeholder meeting to discuss strategies to reduce health disparities through the Exchange.
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.