NAIC task force eyes group market

April 08, 2013 at 10:51 AM
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Members of the Regulatory Framework Task Force are wondering whether they should develop a new model law and a new model regulation that could shake up the entire group health insurance market.

The new models would deal with the provisions in the Patient Protection and Affordable Care Act of 2010 (PPACA) that affect all types of group health plans, not just small-group plans.

The task force, an arm of the Health Insurance and Managed Care Committee at the National Association of Insurance Commissioners (NAIC), is asking members of the public to comment on the idea of an all-group model development project by April 29, according to a task force meeting summary.

The NAIC plenary — the body that includes all voting members of the NAIC — recently approved two major health insurance models developed by the task force: The Individual Market Health Insurance Coverage Model Act and the Small Group Health Insurance Coverage Model Act.

The NAIC has no direct ability to change states' laws or regulations, but states often choose to use the language in the NAIC models in efforts to draft bills and regulatory proposals.

The Regulatory Framework Task Force also has created an Affordable Care Act Model Review Working Group. 

The chair of the working group is Randy Moses, and the NAIC staff support person for the working group is Jolie Matthews.

 The working group is looking at the effects of PPACA on at least 31 NAIC models, ranging from the Standardized Health Claim Form Model Regulation to the Accident and Sickness Insurance Minimum Standards Model Act.

The working group has created a model review worksheet that calls for a working group member to give the purpose for the original model adoption, the number of states that have adopted the model, and, in light of PPACA, the purpose for deciding to delete the model, change the model or keep the model as is.

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