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    Federal Exchange

    If states opt not to establish an exchange, or the exchange does not meet statutory requirements, the federal government will step in and run the exchange.

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    HHS Report on Issuers that Intend to Offer Stand-Alone Dental Plans (SADPs) in FFE States
    HHS has released the attached report that lists the number of issuers that intend to offer stand-alone dental plans (SADPs) in states that are expected to have an FFE (including partnership exchanges). ... read more

    HHS has released the attached report that lists the number of issuers that intend to offer stand-alone dental plans (SADPs) in states that are expected to have an FFE (including partnership exchanges).

    The memo concludes that "Given that there are at least 3 issuers planning to offer SADPs in both markets statewide, we believe that HHS can reasonably expect there to be sufficient SADP coverage to permit QHPs in the FFE in these states to omit the pediatric dental EHB if they choose to do so."

    The report: http://cciio.cms.gov/resources/files/voluntary-dental-reporting-list-1-2....

    Re: HHS Report on Issuers that Intend to Offer Stand-Alone Dental Plans (SADPs) in FFE States
    The National Association of Dental Plans (NADP) and Delta Dental Plans Association (DDPA) surveyed issuers in all states (including state-based exchanges) and are happy to forward similar reports on state-based exchanges upon request. ... read more

    The National Association of Dental Plans (NADP) and Delta Dental Plans Association (DDPA) surveyed issuers in all states (including state-based exchanges) and are happy to forward similar reports on state-based exchanges upon request.

    http://www.nadp.org/index.aspx

    February 13th, '13
    Legislation Regulating Navigators in FFE
    I'm wondering if anyone could offer links or docs related to proposed state legislation that regulates navigators within a federal exchange. Here is Georgia's attempt: http://www.legis.ga.gov/Legislation/20132014/129678.pdf read more

    I'm wondering if anyone could offer links or docs related to proposed state legislation that regulates navigators within a federal exchange. Here is Georgia's attempt: http://www.legis.ga.gov/Legislation/20132014/129678.pdf

    Rachel Dolan
    District of Columbia
    Re: Legislation Regulating Navigators in FFE
    Hi Michelle- This is a very interesting question. It may also be relevant to partnership exchanges, as it seems like the feds will be hiring those navigators as well. We've heard from states that navigators might not be subject to existing licensure... read more

    Hi Michelle- This is a very interesting question. It may also be relevant to partnership exchanges, as it seems like the feds will be hiring those navigators as well. We've heard from states that navigators might not be subject to existing licensure requirements because they are not selling insurance, but haven't seen other legislation like this. How are other partnership and FFE states viewing their role with respect to navigator oversight? Chime in below!

    February 6th, '13
    Tricia Brooks
    District of Columbia
    Re: Legislation Regulating Navigators in FFE
    Hi Michelle, we are very concerned about navigator legislation in states with an FFE. Here's a blog I wrote about the issue. http://ccf.georgetown.edu/all/clogging-state-legislative-agendas-with-mi... read more

    Hi Michelle, we are very concerned about navigator legislation in states with an FFE. Here's a blog I wrote about the issue. http://ccf.georgetown.edu/all/clogging-state-legislative-agendas-with-mi...

    February 19th, '13
    Re: Legislation Regulating Navigators in FFE
    This is the Bill which has been introduced in Tennessee in relation to licensing of Navigators. In reply to Rachel's reply below this bill not only talks about the sale of insurance but the negotiations of insurance contracts as well. Who has authority... read more

    This is the Bill which has been introduced in Tennessee in relation to licensing of Navigators. In reply to Rachel's reply below this bill not only talks about the sale of insurance but the negotiations of insurance contracts as well. Who has authority to regulate or who has oversight of insurance in each state, the state or federal government? And if the federal government then what about the McCarren-Ferguson Act which gave the states authority to regulate insurance? To my knowledge that legislation has not been overturned or overridden?

    February 19th, '13
    Tricia Brooks
    District of Columbia
    Re: Legislation Regulating Navigators in FFE
    That was a quick reply Norm. It's really unfortunate that there is such a tug of war over this issue. Navigators don't sell or negotiate insurance. They are trained to assist individuals in applying for financial assistance, to provide impartial and... read more

    That was a quick reply Norm. It's really unfortunate that there is such a tug of war over this issue. Navigators don't sell or negotiate insurance. They are trained to assist individuals in applying for financial assistance, to provide impartial and accurate information about the full range of QHPs and to help consumers consider the factors that will enable them to select a plan that's right for them. The fact is millions of very-low income people will become eligible for health coverage in 2014. We need all hands on deck to help them successfully enroll. As I see it, many of the navigator bills are trying restrict consumer access to an effective, qualified source of assistance.

    February 19th, '13
    Re: Legislation Regulating Navigators in FFE
    Hello Tricia, actually my reply was not in relation to your right before mine as we must have posted about the same time. I was just replying to Michelle post with a reference to the legislation being proposed in Tennessee. Also I was just asking the... read more

    Hello Tricia, actually my reply was not in relation to your right before mine as we must have posted about the same time. I was just replying to Michelle post with a reference to the legislation being proposed in Tennessee. Also I was just asking the question about who regulates the business of insurance? Evidently some state legislatures feel that it is their responsibility. I'm not trying to start an argument about who should be a Navigator or what they can do. My understand is that exchanges will/could have Navigators and Consumer Assistance Providers. But again not being argumentative but I'll ask again Who has the authority to regulate the business of insurance? Please Google McCarran Ferguson Act and read it. Has the federal government repealed this. If not then the way I understand it each state determines through state statutes who has to be licensed or not and are tasked with defining is selling or negotiating insurance contracts. The insurance policy will be a contract, right? Now I stand to be corrected and maybe federal legislation would override the states legislation. If it does please correct me and provide a reference a can go to understand that. Again just asking questions not trying to debate or be argumentative. I would appreciate anything that any others can add which might clarify the issue.

    February 19th, '13
    Re: Legislation Regulating Navigators in FFE

    The attached Yale Law School brief might give us some insight into who has authority to regulate insurance.......

    February 19th, '13
    Re: Legislation Regulating Navigators in FFE
    And the attached brief from 2011 where Penn State Law School analyses the McCarren Ferguson Act and explains some of the challenges to it and why they have failed. ... read more

    And the attached brief from 2011 where Penn State Law School analyses the McCarren Ferguson Act and explains some of the challenges to it and why they have failed.

    And then the Dodd-Frank bill tried to repeal McCarran-Ferguson but was unable to defeat states rights to regulate health insurance........... he newly established Federal Insurance Office (FIO) and its director shall have authority over all lines of insurance "except" health insurance, long term care insurance (except long-term care insurance included with life or annuity insurance) and crop insurance, which is governed by the Federal Crop Insurance Act. Read the complete article here...... http://www.foxrothschild.com/newspubs/newspubsArticle.aspx?id=15314 Now I'm no lawyer and again I stand to be corrected, but I don't believe Congress has repealed the
    McCarren-Ferguson Act or pierced it in relation to the regulation of health insurance.

    February 19th, '13
    Jade Christie-Maples
    District of Columbia
    Billing in the Federal Exchange
    A webinar listener asked about billing procedures in the FFE and partnership exchanges. See the question and answer here: http://www.statereforum.org/discussions/exchange-policy-decisions#commen... read more

    A webinar listener asked about billing procedures in the FFE and partnership exchanges. See the question and answer here: http://www.statereforum.org/discussions/exchange-policy-decisions#commen...

    replyJanuary 24th, '13
    Rachel Dolan
    District of Columbia
    FL will miss exchange deadline

    FL will not notify HHS today that it wants to run its own exchange, ensuring at least some federal role.

    replyDecember 14th, '12
    Rachel Dolan
    District of Columbia
    VA Rejects State Exchange

    VA Governor McDonnell submitted a letter to HHS on December 14, 2012, indicating that the state would not run its own exchange.

    replyDecember 14th, '12
    Rachel Dolan
    District of Columbia
    PA Rejects State Exchange

    Pennsylvania Governor Tom Corbett sent a letter to HHS on December 12, 2012, announcing that the state would not move forward with a state-based exchange at this time.

    replyDecember 12th, '12
    Rachel Dolan
    District of Columbia
    FAQ on Exchanges, Market Reform and Medicaid

    On December 10, 2012, HHS released an FAQ that addressed issues related to the Medicaid expansion, FFE and partnership exchanges, and market reforms.

    replyDecember 10th, '12
    Jade Christie-Maples
    District of Columbia
    AZ will not pursue a state based exchange

    In a letter to HHS on Nov. 28, 2012, Governor Brewer announced that Arizona will not pursue a state based exchange. According to the Governor, the state will participate in the federal exchange.

    replyNovember 28th, '12
    Rachel Dolan
    District of Columbia
    UT Gov sends letter and questions to HHS

    Utah Governor Gary Herbert sent a letter to HHS Secretary Kathleen Sebelius on November 19, 2012, urging her to answer critical questions related to the federal exchange so that the state can make a decision. The letter and questions are attached.

    replyNovember 20th, '12
    Rachel Dolan
    District of Columbia
    OK will not pursue state based exchange

    OK Gov. Mary Fallin announced on November 19, 2012, that Oklahoma would not pursue a state based exchange.

    replyNovember 19th, '12
    Rachel Dolan
    District of Columbia
    OH will not have state exchange

    On November 16, 2012, Ohio Gov. John Kasich sent a letter to CCIIO informing the federal government that the state would not pursue a state exchange. The letter reserves the right for the state to amend its decision before the blueprint deadline.

    replyNovember 16th, '12
    Rachel Dolan
    District of Columbia
    WI to have federal exchange

    On November 16, 2012, Gov. Scott Walker of Wisconsin sent a letter to Secretary Sebelius stating that WI would have a federal exchange.

    replyNovember 16th, '12

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