Connecticut: Send HIX filings this month

Insurers are supposed to start selling coverage on a guaranteed issue, mostly community-rated basis on that date, and they’re also supposed to use a standardized “essential health benefits” (EHB) package as the basis for the benefits that they offer.

To help consumers shop for coverage, carriers must classify a plan as a bronze, silver, gold or platinum plan. The plan’s “metal level” will depend on the percentage of the actuarial value of the EHB package that the plan provides. 

The Center for Consumer Information and Insurance Oversight (CCIIO) — the agency responsible for implementing much of PPACA — has been developing an actuarial value calculator that’s supposed to simplify the process of estimating a plan’s actuarial value, but the calculator is not yet available.

Details

The Connecticut department wants an insurer to indicate whether a form is for a bronze, silver, gold or platinum product by using a B, S, G or P.

The department is not saying whether the HIX prefix should come before the metal level prefix or if the metal level prefix should come before the HIX prefix.

“The filing should include a certification by a member of the American Academy of Actuaries regarding the calculation of the actuarial values of the metal levels,” department officials said.

Because the CCIIO has not yet published a calculator for determining the actuarial value of the EHB package, “policy forms and certificates may be filed without the schedule of benefits so as not to delay the review and approval of these forms,” officials said. “The schedules of benefits may be filed at a later date with a target date not later than January, 2013.”

See also:

• Kansas rep lobbies for HSAs
• PPACA: IRS Offers 3 Plan Valuation Methods
• CCIIO Proposes HSA Plan Valuation Approach