Based on documents submitted on State Refor(u)m, North Dakota has made 88 percent progress by completing 15 milestones toward the category: Insurance Exchanges

Implementation Milestone Checklist

• Decide whether to establish a state, sub-state, or multi-state Exchange or defer to the federal government *
• Solicit stakeholder input on Exchange design *
• Determine policy goals for the Exchange *
• Establish governance of the Exchange *
• Define the health plan selection strategy of the Exchange *
• Develop an implementation plan and timeline for building an Exchange that will be operational on or before January 1, 2014 *
• Develop IT infrastructure specifications for the Exchange *
• Develop specifications for a user-friendly Exchange website and a call center for exchange customer service *
• Adopt provider network standards for Exchange plans that meet or exceed those required by federal laws and regulations *
• Adopt a plan rating system that meets or exceeds standards developed by the federal government *
• Develop enrollee billing procedures and allocate responsibilities among the Exchange, employers and qualified plans *
• Determine how health plan benefit design in the Exchange will meet federal standards for essential benefits and tiers
• Develop a plan for making the Exchange financially self-sustaining by 2015 *
• Develop a strategy for educating consumers and employers about their rights and responsibilities regarding the Exchange
• Test the Exchange's functionality with individual and small employer users *
• Develop financial reporting, audit, internal controls, accounting policies, and other related practices for the Exchange *
• Develop a simple process through which small businesses can purchase insurance for their employees through the Exchange *
• *North Dakota, a federally facilitated exchange state, has been awarded automatic credit for milestones denoted with an asterisk because the federal government will carry out those tasks.