Arkansas Gov. Mike Beebe, D (Governor's office photo)

LITTLE ROCK, Ark. (AP) — The new Arkansas Patient Protection and Affordable Care Act (PPACA) health insurance exchange system has attracted four medical plan providers.

The “qualified health plan” (QHP) providers include three traditional insurers – Arkansas Blue Cross Blue Shield, Celtic Insurance Company/NovaSys Health and QualChoice of Arkansas — and a National Blue Cross Blue Shield multi-state plan (MSP).

PPACA requires the U.S. Department of Health and Human Services (HHS) and state regulators to set up exchanges, or health insurance supermarkets, in all 50 states and the District of Columbia by Oct. 1.

States can set up their own exchanges, let HHS provide exchanges for their residents, or share the job with HHS through a “partnership exchange” arrangement.

Arkansas is one of seven states using the partnership model for running its health exchange. The state has received more than $43 million from the federal government to set up the exchange.

Officials are predicting that the state’s exchange could attract about 500,000 state residents.

The MSP is a new type of health plan. Drafters of PPACA created the MSP program — which is supposed to let a plan operate in multiple states without facing as much state oversight as a typical multi-state carrier — in an effort to increase the level of competition in states in which one or two carriers dominate the individual market, the small-group market or both.

The Arkansas Insurance Department announced the QHP notice results Tuesday.

“I am pleased with the level of participation the industry continues to show,” Insurance Commissioner Jay Bradford said in a statement. “It has always been my desire, and in the best interest of the Arkansas consumer, to have as much competition and choice as possible on the Health Insurance Marketplace.”

The next step for the department will be to review the companies’ planned service areas to make sure they meet a requirement that consumers in each of the state’s 75 counties have a choice among at least two health insurance carriers, Exchange Planning Director Cindy Crone said.

“If it appears there’s not, he can reach back out to companies who provided a letter of intent or others and see what he can do about ensuring that coverage and choice,” Crone said of Bradford. “We’re thinking optimistically that we’ll have two choices.”

Crone had initially told lawmakers she hoped at least six insurers would participate in the plan, but said Tuesday she was still satisfied with the number initially interested.

“I think I’ve said all along I’d be tickled if we had four plans and I’d like us to have six or more,” Crone said. “I think we’re in a good place.”

Rep. John Burris, chairman of the House Public Health Committee, said he was pleased with the number of insurers interested in the plan and said he expected the number participating to rise in future years.

“Four is a good starting point,” said Burris, R-Harrison. “Year one is the hardest because you don’t know what to expect.”

The companies face a June 30 deadline to file their applications to participate in the exchange, which will include information on the cost for policies, Crone said.

Under the partnership model that Arkansas is using, the federal government will be responsible for several areas, including eligibility determinations, enrollment of individuals and operating a call center. The state will determine criteria for certifying health insurance plans, monitoring plans for continued participation, providing direct consumer outreach and education, and providing consumer complaint resolution.

About half of the people who will buy insurance through the exchange are doing so under a plan lawmakers approved earlier this year to buy private insurance for low-income residents using federal Medicaid funds. The “private option” was approved as an alternative to expanding Medicaid’s enrollment under PPACA.

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