The HHS’s Final Rule on Health Exchanges and Essential Health Benefits LIVE Webcast
Pursuant to the Affordable Care Act (ACA), the U.S. Department of Health and Human Services (HHS) recently issued a final rule effective April 2013 that sets forth the future of health insurance exchange and insurance issuer standards with respect to the coverage of essential health benefits (EHB), actuarial value and accreditation requirements for individual and small group markets. The final rule details state-specific benchmark plan which allows each state to choose from several options or default to a designated benchmark plan. It also outlines ways to determine whether employer-sponsored self-insured group health plans and insured large group health plans meet the MV standard. Now that the final rule has come into fruition, CMS, state insurance regulators and employers are left with questions regarding enforcement and coordination between state and federal agencies. And perhaps most importantly: how might the essential health benefits change in 2016 and how will new state mandates fit in with a market that has begun to adjust to the new world of the Affordable Care Act?
The Knowledge Group is producing this LIVE webcast which will explore the issues and concerns surrounding this change and will provide valuable information and analysis on how your company should be progressing towards compliance in order to avoid the risk of potential pitfalls and penalties.
Kelly Brantley, Senior Manager,
- ACA and regulations have defined essential health benefits (EHB)
- Scope of benefits will be relatively generous but will still vary across states
- Access concerns will center on cost sharing more than coverage
- Some states have standardized benefits to make coverage more comparable
- Initial premium filings offer some insight into plan availability
- Expected timing on updated EHB regulations for 2016
Jon M. Hager, Executive Director,
Silver State Health Insurance Exchange
- Nevada’s process to select its recommended EHB benchmark plan
- The effect EHB rules had on mandates introduced during the legislative session
- Adverse selection between fully insured and self-insured markets. Is there going to be a shift to self-insured?
- State v. Federal enforcement of EHB and other market rules. Lawsuits?
- How will the EHB rules and benefits change in 2016?
Victor L. Moldovan, Partner,
** Speaker Talking Points to be added soon.. **
Who Should Attend:
- Insurance Carriers
– Plan Sponsors
– Health Insurance Companies
– Health Care Law Attorneys
– Insurance Attorneys
– Senior Corporate Management
– Health Care Advisory Services Consultants
– Health Policy Directors
– Healthcare Finance People
– Third Party Administrators
– Employee Benefits Attorneys
– State Health Executives
– Human Resource & Benefits Personnel
– And Other Interested/Related Professionals
Kelly Brantley provides strategic analysis to help clients assess and respond to health insurance marketplace reforms, including the Affordable Care Act. Her areas of expertise include health insurance exchanges, essential health benefits, actuarial value, Medicare, and insurance market regulation. Kelly also focuses on the impact of health reform on consumers.
Prior to joining Avalere, Kelly spent five years at the Health Assistance Partnership, a project of Families USA, where she worked closely with State Health Insurance Assistance Programs (SHIPs). Before Families USA, Kelly consulted for the ECRI Institute, where she analyzed online tools promoting quality health and healthcare.
Kelly holds a B.S. in Biology from the University of North Carolina at Chapel Hill as well as an M.P.H. in Health Promotion and a Graduate Certificate in Health Policy from the George Washington University School of Public Health and Health Services.
Kelly Brantley provides strategic analysis to help clients assess and respond to health insurance marketplace reforms, including the Affordable Care …
Jon M. Hager was appointed as the first Executive Director of the Silver State Health Insurance Exchange in January 2012 by unanimous vote of the Exchange Board in an open interview process.
Prior to 2012, Mr. Hager was the Chief Financial Officer of Nevada’s Public Employees’ Benefits Program and was responsible for the Program’s $476 million annual budget which served 72,000 state and local government employees, retirees and dependents.
Mr. Hager served as a pilot in the U.S. Navy for nine years. He earned his MBA from Texas A&M and a BS in Physics from the United States Naval Academy.
Jon M. Hager was appointed as the first Executive Director of the Silver State Health Insurance Exchange in January 2012 …
Victor has practiced law since 1986, primarily for healthcare clients, including ambulatory surgery centers, physician clinics, hospitals, radiation therapy centers, imaging providers, home health companies, hospice agencies, and independent physician associations. The scope of his practice includes compliance with federal and state statutes and regulations, litigation before administrative bodies and state and federal courts, medical peer review issues, drafting and commenting on legislation and regulations, testimony on healthcare laws, certificate-of-need applications and appeals, employment-related issues, managed care, contract preparation and negotiation, trademark and trade name disputes.
Victor has practiced law since 1986, primarily for healthcare clients, including ambulatory surgery centers, physician clinics, hospitals, radiation therapy centers, …
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Silver State Health Insurance Exchange
About Avalere Health
Avalere Health combines substantive insight and unparalleled analytics to ignite real solutions. Powered by an extraordinary team of healthcare industry executives and former government officials, we partner with life sciences, health plan, and provider organizations to improve the healthcare system.
About Silver State Health Insurance Exchange
About McGuireWoods LLP
McGuireWoods provides legal services to public, private, government and nonprofit clients in a variety of industries. We also offer ancillary business and strategic services outside the legal realm that are provided by McGuireWoods Consulting LLC.