Healthcare Business News

Proposed requirements for multistate plans worry insurers

By Virgil Dickson
Posted: February 10, 2014 - 11:00 am ET

Insurers are concerned that proposed requirements for the healthcare reform law's multistate insurance plans may be too cumbersome.

Multistate plans, also known as MSPs, are meant to increase competition among the health plans offered through the exchanges established under the Patient Protection and Affordable Care Act. The law designated the U.S. Office of Personnel Management, which is responsible for the Federal Employees Health Benefits Program, to oversee the multistate plans.

Consumers in Alaska, New Hampshire and West Virginia would have access to only one type of insurance plan without the multistate plans, according to the Office of Personnel Management.

The OPM is circulating a letter (PDF) that outlines what plans are expected plans to cover in 2015.

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Starting next year, the contracts will obligate the multistate plan issuers to offer both individual and family coverage at the silver and gold levels and will not accept applications for stand-alone dental plans.

The OPM is also pushing to ensure the plans have adequate provider networks, a concern that the CMS addressed last week in its own letter to payers looking to offer plans on the exchanges in 2015.

Policy experts say it's not a surprise that multiple federal agencies are pushing insurance companies to have quality provider networks on the exchanges.

“Insurers slapped these networks together,” said Jeff Goldsmith, a health insurance expert and founder of Health Futures, a consultancy specializing in corporate strategic planning and forecasting future healthcare trends. “There are times where even health plans don't know for sure if a provider is in the network. They might think someone is, only to find out the contract was never finalized.”

The Affordable Care Act stipulated that the plans must be offered in at least 60% of states in 2014 and that at least two multistate plans be operating in all 50 states by 2017. Last year, the Blue Cross and Blue Shield Association won a contract to offer 150 MSP options in 30 states and the District of Columbia.

Some Blues plans, though, are not happy with the proposed requirements for next year's plans.

“Some of the requirements in the letter, if they are contained in the final contract with OPM, will produce significant operational challenges,” said Dianne Nodier Eysink, a spokeswoman for Blue Cross and Blue Shield of Louisiana.

The letter has also given Blue Cross and Blue Shield of Kansas some “concerns we will share with regulators,” Blue Cross and Blue Shield of Kansas spokeswoman Mary Beth Chambers said.

Follow Virgil Dickson on Twitter: @MHvdickson

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