NAIC Health Reform Update – December 19, 2011

I. NAIC Health Reform OPEN Conference Call List for the Week of December 19

Attached is the list of OPEN calls for this week.

II. Notes from NAIC Forum on Exchange Plan Management

Attached is a summary of discussions at the recent Exchange Plan Management forum hosted by SERFF.

The NAIC hosted its second Health Insurance Exchange Plan Management Forum Dec 12-14 in Washington, DC. A summary of the daily activities during the forum is attached. This meeting brought together state insurance regulators from some 30 states, representatives of national and regional insurance companies and the Department of Health and Human Services to discuss plan management, one of the five core functions of exchanges as described by HHS. The components of Plan Management were identified and discussed. From there participants discussed the pieces of exchange insurance plans, the process insurers might use to submit policy forms and rates, how the states would complete their review, and how the data and information contained in filing submissions could be shared with each of the states’ health exchanges. There was general agreement among those attending on a number of issues including the existing role of state regulators in plan management type functions, the desire to have a single data format, and that SERFF is a logical primary workflow tool for plan management supporting an exchange. The need for regulatory simplicity and efficiency was stressed by states and companies, emphasizing the need to leverage existing systems in exchange development.

There was a collective sense of urgency expressed given the requirements of the law. Under the provisions of PPACA, exchanges must be ready to start enrolling consumers into insurance plans on October 1, 2013, which implies the exchanges must be functional by early to mid-2013 to allow issuers to get their plans submitted, reviewed, approved and published on an exchange. NAIC staff will continue to offer coordination and collaboration opportunities related to plan management for state and federal regulators as well as interested parties from the industry. If you would like to be included in the interested parties distribution list for the NAIC HIX Plan Management Project please contact Terri Hiebert at
Plan Management – Daily Summaries (2).pdf
Health Reform Call Calendar 12-19-2011 – Open.doc


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