Insurers to exchange: You're not my regulator

The staffers suggested, for example, that a carrier that sells through the exchange should have to consult with the exchange on changes in its service area, covered drug list or network capacity, because those are matters that could have an immediate, dramatic effect on an enrollee’s experience.

Some carriers have asked about model passages that refer to an “administrative manual” that has not yet been developed.

The exchange could defer creation of the manual at this time and work with the “qualified health plans” (QHPs) that sell coverage through the exchange to develop the business rules on operational interfaces and other requirements, the staffers said.

In a section on language requirements, staffers suggested limiting requirements for support for languages other than English to Spanish.

But the exchange should keep the Spanish-language support requirements, because as many 50 percent of the exchange users could be speakers of Spanish, the staffers said.

QHPs will not have to start asking enrollees to volunteer sensitive information, such as information about “race, ethnicity, sexual orientation, gender identity and disability status” until 2015.

QHPs will have to start asking enrollees for that information in 2015, because “reducing health disparities is a key goal,” staffers said.

See also:

• California exchange picks SHOP administrator
• Calif. exchange to pay “competitive” commissions
• California exchange builders: Agents warming up