InsideHealthPlan.com: HHS Exchange Timeline

HHS Gives States Insight Into Expected Timeline On Plan Certification Process

Posted: January 12, 2011

A key HHS official during a recent conference call with states provided some insight into the timeline that HHS expects states to follow in order to get qualified health plans certified to sell in the health insurance exchanges, which must be active by January 2014. Henry Chao, the chief information officer for the Consumer Information and Insurance Oversight Office, said that if HHS intends to hold an open enrollment period with a reasonable window — starting in the third or fourth quarter of 2013 — then the certification process should have a 9 to 12 month lead time.

Chao also signaled that the administration will consider adopting some of the technologies and strategies proposed by the “early innovator” states for its own health insurance exchange.

He made the comments in response to questions from state officials during a Dec. 14 conference call discussing the early innovator grants that HHS plans to award on Feb. 15.

The reform law lets states choose to either run their own individual and small group (known as SHOP) health exchanges, or to allow HHS to sell insurance through a federally administered exchange. State sources have consistently said that most states intend to operate their own exchanges.

Under the law, in order to participate in the exchange an insurance product must be certified as a “qualified health plan.” Considering the time it will take to actually go through the certification process, including plan evaluation, rating and contracting, states will probably need a lead time between 9 and 12 months prior to the open enrollment process, Chao indicated. He also said that in order to provide a reasonable window for consumers to enroll, the open enrollment period would need to begin in the third or fourth quarter of 2013.

“So that kind of informs you about what capabilities you have to have in 2012 to be able to support enrollment by 2013,” he said.

In response to a query about whether it is the intent of the grant to use any of the components developed in the federal model, Chao said that “the short answer is yes.

“I think that definitely … something that would make sense in a federally operated exchange situation; that it would not be significantly — or really any different — than the same requirements that any exchange would perform,” he said.

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