Filed Under:Health Insurance, Individual Health

D.C. exchange to start with menu plans on menu

The board of the District of Columbia Health Benefit Exchange Authority -- the "HBX" -- wants the HBX to start life with a feature that will wow small-employer users.

The HBX board has decided that the D.C. "Small Business Health Options Program" (SHOP) exchange will let a small employer customer offer workers a plan menu program that includes all group plans available at a designated level of coverage.

An employer also could offer employees a choice of all health plans offered by one insurer in two "contiguous levels," or simply offer one plan with one level of coverage.

The authority also "will collect data to examine the effectiveness of this approach, including a survey of employers and employees, an analysis of premiums, and options to further expand choice," HBX board officials said.

The HBX board is going beyond what the U.S. Department of Health and Human Services (HHS) will require.

Originally, HHS was going to require all SHOP exchanges to offer small employers access to plan menu programs in 2014. In March, HHS officials postponed the start date for the plan menu program requirement until 2015.

If the Patient Protection and Affordable Care Act of 2010 (PPACA) takes effect as written and works as expected, it is supposed to require residents of all 50 states and the District of Columbia to have access to exchanges, or Web-based health insurance supermarkets, for individuals and small groups by Oct. 1.  

The District of Columbia decided to set up its own exchange, rather than having HHS officials set up an exchange for its residents.

PPACA also is set to require issuers of all non-grandfathered individual and small group coverage to cover a standard "essential health benefits" (EHB) benefits package, or the equivalent, and to sell plans that fit into one of four different "metal levels" of coverage, with the coverage levels ranging from about 60 percent of the actuarial value of the EHB for bronze coverage; about 70 percent for silver coverage; about 80 percent for gold coverage; and about 90 percent for platinum coverage.

The new board decision means that a small employer that uses the D.C. SHOP will be able to offer employees an "any bronze plan" or an "any silver plan" program, authority officials said.

Authority officials hope to get non-binding letters of intent from the insurers that will offer plans through the exchange in 2014 by April 15.

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Nichole Morford

Nichole Morford
Managing Editor

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