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HHS issues further guidance on exchanges


By Jessica Zigmond
Posted: September 19, 2011 - 2:30 pm ET
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HHS on Monday published additional guidance on the state partnership model for health insurance exchanges that the agency outlined in a proposed rule earlier this summer.

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The model is intended to give the states another option as they establish exchanges that are well-suited to their local market conditions and also help them transition into operating those healthcare insurance marketplaces.

Under this state partnership model, states can follow the so-called plan-management function, which includes the collection and analysis of plan information, plan monitoring and oversight, and data collection and analysis. According to HHS, the agency will coordinate with the plan regarding oversight, including consumer complaints and any issues regarding enrollment reconciliation.

A second option is the consumer-assistance function, in which states would oversee in-person consumer assistance, manage the Navigator program—which will offer direct assistance in helping people sign up for insurance—and conduct education and outreach. States could also opt to incorporate both the plan-management and consumer-assistance models, according to HHS.

The agency will continue to accept public comments about its July 15 proposed rule on the state partnership model until Sept. 28.


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