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:
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.
On January 31, 2013 the New York Health Benefit Exchange issued its invitation to health insurers and dental plans to participate in the New York Health Benefit Exchange. The invitation and related documents are listed below. Please note that the invitation is comprised of 13 documents. Each document is posted in PDF format as well as Microsoft Word/Excel format for ease of use.
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.
On November 26, 2012, the U.S. Department of the Treasury, Department of Labor and Department of Health and Human Services issued a proposed rule on incentives for nondiscriminatory wellness programs in group health plans.
On November 20, 2012, New York submitted a Level 2 Exchange Establishment Grant application to support the establishment and on-going development of New York's Exchange through December 31, 2014. The State received an award of $185.8 million for this grant on January 17, 2013. New York received a supplemental award of $41 million for this grant on September 20, 2013.
On December 5, 2012, the U.S. Office of Personnel Management (OPM) issued a proposed rule on Establishment of the Multi-State Plan Program for the Affordable Insurance Exchanges. This proposed rule would implement the Multi-State Plan Program. Through contracts with OPM, health insurance issuers will offer at least two multi-State plans on each of the Exchanges. Comments were due by January 4, 2013.
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.
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.