Filed Under:Health Insurance, Individual Health

Insurers to exchange: You're not my regulator

The board will consider the third draft of the model Tuesday.
The board will consider the third draft of the model Tuesday.

Carriers thinking about selling plans through the Covered California health insurance exchange program "don't want Covered California to be a 'third regulator.'"

Staffers on the board of Covered California -- the California Patient Protection and Affordable Care Act (PPACA) health insurance exchange -- have included a discussion of that issue in the third draft of a model plan contract the exchange is developing.

The staffers suggested, for example, that a carrier that sells through the exchange should have to consult with the exchange on changes in its service area, covered drug list or network capacity, because those are matters that could have an immediate, dramatic effect on an enrollee's experience.

Some carriers have asked about model passages that refer to an "administrative manual" that has not yet been developed.

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Nichole Morford

Nichole Morford
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