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 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.
On June 28, 2012, New York submitted a Level One application for the federal Exchange Establishment grant. The State received an award of $95.5 million for this grant on August 23, 2012. New York received a supplemental award of $19 million for this grant on September 20, 2013.
On August 2, 2012, the Health Benefit Exchange convened stakeholders to discuss preliminary results of Milliman's Essential Health Benefits study. There was an open public comment period and attendees were invited to provide feedback.
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.
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.