CMS Releases Final Summary Of Benefits And Coverage Template, Accompanying Materials (Update)

Implementing Health Reform (April 11 Update on Vertical Choice). In the 2017 Benefit and Payment Parameters rule the Centers for Medicare and Medicaid Services (CMS) created a new option for employer choice in the federally facilitated Small Business Health Options Program (SHOP) exchanges and in state-based exchanges that use the federal enrollment platform (SBE-FP states): vertical choice. In the first year of operation of the FF-SHOP, 2014, employers could only choose a single plan to offer their employees. In the second year, 2015, a second option became available in states that permitted it: “horizontal choice.” Under horizontal choice, an employer could elect to let its employees choose any health plan at the same metal level. In the third year, 2016, horizontal choice became available in all FF-SHOP states. Under vertical choice, employers can allow their employees to choose plans at any metal level offered by a single insurer. For 2017, however, states were given the option of recommending against allowing vertical choice in their states if they believed that vertical choice would have an adverse effect on their small group market and consumers. State recommendations were due by March 25, 2016. On April 8, 2016, CMS announced that vertical choice will be available in 21 states that use the FF-SHOP enrollment platform: Alaska, Delaware, Florida, Georgia, Illinois, Iowa, Kansas, Louisiana, Maine, Missouri, Montana, Nevada, New Hampshire, North Dakota, Ohio, Oklahom...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Following the ACA Insurance and Coverage advanced premium tax credits SHOP exchanges States Summary of Benefits And Coverage Source Type: blogs