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 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.
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.