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:
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.
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.
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.
The New York State Department of Health submitted comments on the interim rules issued as part of the March 27, 2012 final rules establishing health insurance exchanges and the March 16, 2012 final rules for Medicaid program eligibility changes under the Affordable Care Act. Comments on the Medicaid program rules were due by May 7, 2012. Comments on the Exchange rules were due by May 11, 2012.
Governor Cuomo issued Executive Order #42 to establish a statewide Health Exchange on April 12, 2012. The Executive Order established the New York Health Benefit Exchange within the Department of Health.
On February 24, 2012, the U.S. Department of Health and Human Services (HHS) released a bulletin on calculation of actuarial value and cost-sharing. The purpose of this bulletin is to provide information and solicit comments on the regulatory approach that HHS plans to propose to define actuarial value for qualified health plans and other non-grandfathered coverage in the individual and small group markets as well as to implement cost-sharing reductions under the Affordable Care Act. Comments on this bulletin were due by March 27, 2012.
On December 16, 2011, the U.S. Department of Health and Human Services (HHS) released a bulletin on the essential health benefits. The purpose of this bulletin is to provide information and solicit comments on the regulatory approach that HHS plans to propose to define essential health benefits under the Affordable Care Act. Comments on this bulletin were due by January 31, 2012.