Understanding,the,differences, technology Understanding the differences among regional, multi-state or
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Health Insurance Exchanges, the one-stop online marketplaces to sell commercial health insurance, are set to come into operation by January 1, 2014. In addition to finalizing the infrastructural and design aspects and requirements, states also need to decide whether they will be setting up an exchange on their own or would prefer deferring it to the federal government. Not only this, the states also need to decide if they will have a single health insurance exchange that serves the entire state, multiple exchanges that cater to different regions within a state, or a multi-state exchange that serves two or more states.Considering the administrative and operational intricacies and technical complexities involved in the setting up and operating an exchange, it is difficult to imagine how operating more than two exchanges in a particular state would aid in efficient use of state resources.It is possible that certain health plans may be available in only a select few regions within the state and even then the costs of health plans may vary from region to region. A single state-wide health insurance exchange, with its smart technology setup and easy to use interface, can help consumers across the entire state to get the latest information about the different carriers operating within a state, the health plans offered by them and the varying premium rates. For such cases, setting up a single state-wide exchange will make more business sense.A health insurance exchange will not just serve as a portal to sell insurance, but will be responsible for executing several auxiliary regulatory responsibilities as well. Exchanges will provide consumers a one-stop place to check their eligibility for any health plans, federal subsidies or tax credits. Exchanges may also be responsible for selecting participating health insurers, setting and finalizing premium rates to standardize costs and improve quality of care, determine exemption from individual mandate etc. Setting up separate regional exchanges within the state may not add much value or advantage to state residents.Consumer outreach programs and educational drives to inform state residents on the type of health plans available etc. can be handled at a regional level. Again, these decisions may be dependent on the size of the state and the way the insurance is presently administered in the states.Multi-state exchanges may have its benefits with multiple states joining their resources together to establish and operate an exchange and manage the backend administrative functions. Eligibility and enrollment processing, customer support and member services, setting premium rates etc. are several administrative tasks that need to be taken care of by exchanges.Several of these functionalities will be similar across all the exchanges and the states may find it beneficial to join forces and run a multi-state exchange. However, as insurance regulations vary from state to state, insurance regulations across different states would need to be standardized before a multi-state exchange can be set up.
Understanding,the,differences,