A committee at the National Association of Insurance Commissioners (NAIC) has signed off on the American Health Benefit Exchange Model Act.
The Health Insurance and Managed Care Committee endorsed the model Monday and officially agreed to expose it to the public, to seek comments, according to officials at the NAIC, Kansas City, Mo.
The committee’s Exchanges Subgroup developed the model to implement the Affordable Health Benefit Exchange provisions of the Affordable Care Act, the legislative package that includes the Patient Protection and Affordable Care Act (PPACA), and the Small Business Health Options Program (SHOP) provisions.
The health benefit exchange provisions require states to set up exchanges that individuals and families can use to buy subsidized health coverage. The SHOP Exchange provisions require states to set up exchanges that can help small businesses buy coverage.
The 11-page model includes a definitions section, a description of the duties of an exchange, a section on certifying whether a health benefit plan is qualified to participate in an exchange, and a section on funding.
In the version approved by the Health Insurance and Managed Care Committee, drafters say in a note that states can combine their individual health benefits exchange and SHOP exchange programs. But a state can merge the programs “only if the Exchange has adequate resources to assist these individuals and employers,” the drafters say. “States that do so will need to