The Health Practice Council’s Individual and Small Group Markets Committee submitted comments to the Centers for Medicare & Medicaid Services regarding the proposed rule for the 2025 Notice of Benefit and Payment Parameters.
( )The Individual and Small Group Markets Committee submitted comments to the Centers for Medicare & Medicaid Services’ Center for Consumer Information & Insurance Oversight (CCIIO) on the Draft 2025 Actuarial Value (AV) Calculator Methodology.
( )The Health Practice Council’s Individual and Small Group Markets Committee, Risk Sharing Subcommittee, and Active Benefits Committee submitted a comment letter to the Department of Health and Human Services (HHS), Department of Labor (DOL), and the Department of the Treasury on the Short-Term, Limited-Duration Insurance; Independent, Noncoordinated Excepted Benefits Coverage; Level-Funded Plan Arrangements; and Tax Treatment of Certain Accident and Health Insurance notice of proposed rulemaking (NPRM).
( )The Individual and Small Group Markets Committee released its annual issue brief laying out the factors underlying premium rate setting and highlighting the major components driving premium changes in the individual and small group markets for 2024.
( )Academy Senior Health Fellow Cori Uccello presented on “Considerations for Calculating Cost-Sharing Reduction Load Factors” at the Society of Actuaries’ virtual health meeting.
( )The Health Practice Council’s Individual and Small Group Markets Committee and Risk Sharing Subcommittee submitted a comment letter to the Centers for Medicare & Medicaid Services’ (CMS) proposed rule for the 2024 Notice of Benefit and Payment Parameters (NBPP).
( )The Individual and Small Group Markets Committee submitted comments to the Centers for Medicare & Medicaid Services’ Center for Consumer Information & Insurance Oversight (CCIIO) on the Draft 2024 Actuarial Value (AV) Calculator Methodology.
( )Presentation at the National Association of Insurance Commissioners (NAIC) Affordable Care Act (ACA) State Rate Review Discussion Meeting on Considerations for Calculating Cost-Sharing Reduction (CSR) Premium Load Factors.
( )The Individual and Small Group Markets Committee and its Risk Sharing Subcommittee submitted a letter to the CCIIO on cost-sharing reduction (CSR) premium load factors. The letter was also submitted to state regulators and legislators. The letter first discusses using actual experience data/issuer pricing models to develop the load factor. It then discusses a method using federal actuarial value (AV) levels to develop the load and potential drawbacks of this approach.
( )This infographic illustrates the factors underlying premium rate setting and highlighting the major components driving premium changes in the individual and small group markets for 2023, that are discussed in the recently released issue brief.
( )The Individual and Small Group Markets Committee released an issue brief laying out the factors underlying premium rate setting and highlighting the major components driving premium changes in the individual and small group markets for 2023.
( )The Individual and Small Group Markets Committee submitted comments to the Centers for Medicare & Medicaid Services’ Center for Consumer Information & Insurance Oversight (CCIIO) on the Draft 2023 Actuarial Value (AV) Calculator Methodology.
( )The Health Practice Council’s Individual and Small Group Markets Committee, Risk Sharing Subcommittee, and Health Equity Work Group submitted a comment letter to the Centers for Medicare & Medicaid Services (CMS) on CMS’ proposed rule for the 2023 Notice of Benefit and Payment Parameters (NBPP). The letter addresses network adequacy, standardized plan options, several provisions on health equity, updating quality improvement strategy standards and other topics.
( )The Risk Sharing Subcommittee submitted comments to the Centers for Medicare & Medicaid Services (CMS) Center for Consumer Information and Insurance Oversight (CCIIO) on the HHS-Operated Risk Adjustment Technical Paper on Possible Model Changes, exposed for comment on Oct. 26, 2021.
( )The Individual and Small Group Markets Committee and its Risk Sharing Subcommittee comments to the Centers for Medicare & Medicaid Services (CMS) on the proposed rule, Updating Payment Parameters, Section 1332 Waiver Implementing Regulations, and Improving Health Insurance Markets for 2022 and Beyond.
( )The Health Practice Council’s Individual and Small Group Markets Committee and the Active Benefits Subcommittee comments to the Departments of Health & Human Services, Labor, and the Treasury as the agencies develop proposed rules related to the recently enacted No Surprises Act pertaining to surprise medical billing.
( )Health Equity Work Group (HEWG) Discussion Brief – Issue in Focus, Health Equity From An Actuarial Perspective: A Deeper Dive Into Health Plan Pricing. This discussion brief, which focuses on questions related to pricing health insurance products, is part of a series to identify areas that may affect health equity. An introductory discussion brief provided an overview of the HEWG’s work.
( )Telehealth Work Group issue brief on telehealth coverage and payment considerations for policymakers now and after the COVID-19 public health emergency.
( )The Health Practice Council submitted a comment letter to the Department of the Treasury, the Department of Labor (DOL), and the Department of Health & Human Services (HHS), on review of agency actions related to the Affordable Care Act and Medicaid, as put forward in a recent presidential executive order. The letter provides references to previous Academy comment letters to agencies regarding relevant proposed rules.
( )The Individual and Small Group Markets Committee and its Risk Sharing Subcommittee comments to the Centers for Medicare & Medicaid Services (CMS) on the Proposed Notice of Benefit and Payment Parameters for 2022.
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