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February 19, 2015 at 08:10 AM
The U.S. Department of the Health and Human Services (HHS) is still propping the door open for the 2015 open enrollment period at the public exchanges it runs, but it’s already posted applications for insurers that want to sell coverage through HHS exchanges in 2016.
The Center for Consumer Information & Insurance Oversight (CCIIO), the HHS division in charge of the exchange program, has posted the 2016 qualified health plan (QHP) application packet along with a variety of QHP application instructions and templates.
Major QHP application areas cover topics such as whether a would-be QHP issuer is properly licensed, whether it’s in good standing with state insurance regulators, whether it has accreditation from major health plan quality organizations, and whether its provide network has enough of the right kinds of health care providers in the right places.
Other areas deal with matters such as whether a QHP offers the Patient Protection and Affordable Care Act (PPACA) essential health benefits or acceptable substitute benefits; what drugs a QHP covers; and whether a QHP has benefits that regulators view as discriminatory.
