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.
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.
This report explores the critical interactions that third party assistors have with buyers and sellers of insurance in the New York market and presents various models for incorporating and compensating producers and other intermediaries in the New York Health Benefit Exchange.
This memo summarizes the effects of the Patient Protection and Affordable Care Act of 2010 (ACA) on state Medicaid spending in New York. The estimates in this memo are based upon results from a complete simulation using the Urban Institute’s Health Insurance Policy Simulation Model, New York Version (HIPSM -NY) and are intended to provide analytic support to the state’s policymakers.
The Patient Protection and Affordable Care Act of 2010 (ACA) provides states with the opportunity to develop health benefit exchanges – structured marketplaces for the purchase of health insurance coverage by small employers and individual purchasers. If New York State elects to do so, the law provides an array of design choices to the states in an effort to allow the exchanges to reflect varying preferences across the country.