AIS’s Health Insurance Exchange Directory and Factbook

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Publication Details

  • Pub Code: GHEX1-11WEB
  • Pages: 604
  • ISBN: 978-1-936230-60-0
  • Copyright 2013

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AIS’s Health Insurance Exchange Directory and Factbook

The definitive health industry guide to health insurance exchange implementation and stakeholder strategies, with in-depth coverage of every big-dollar business issue related to the new marketplaces — including technological infrastructure, consumer support tools, benefit design, marketing, FFEs and much more. Also contains practical summaries of exchange regulations and controversies, plus three unique directories: exchanges by type, exchange professionals, appointees and experts, and exchange vendors. The CD edition contains all these directories in Excel, mailing lists and much, much more.

Place your order through our secure shopping cart

$385.00
$575.00

A Guide to Implementation and Stakeholder Strategies

The new health insurance exchange marketplaces, public and private, will have a profound impact on the under- and uninsured … and will permanently alter the way health insurance is bought and sold. AIS’s Health Insurance Exchange Directory and Factbook is the definitive health industry guide to insurance exchange implementation and stakeholder strategies.

In more than 600 information-packed pages, this valuable directory and answer-book provides in-depth coverage of every big-dollar business issue related to the new marketplaces, including:

  • Technological infrastructure and human resources
  • Consumer support tools and resources
  • Essential health benefits
  • State-by-state exchange strategies and decision
  • Federally facilitated exchanges
  • Exchange marketing initiatives and responsibilities
  • Insurer perspectives on public exchanges
  • Benefit design in the exchange era
  • Pharmacy benefits and exchanges
  • Selling products on exchanges
  • Challenges and opportunities for employers
  • Private exchange models
  • Market impact and exchange proliferation

AIS’s Health Insurance Exchange Directory and Factbook also contains practical summaries of exchange regulations and controversies (Medicaid expansion, employer mandate, SHOP, multistate plans, the individual mandate and more) and three unique directories that were compiled recently by AIS’s experienced database/directory staff:

  1. Directory of Exchanges by Type (e.g., public/private, multi-carrier/single carrier, FFE/State/Partnership) with their addresses, websites, market geography and size, IT platform/vendor, and other pertinent data.
  2. Directory of Exchange Professionals, Appointees and Experts, with contact information.
  3. Directory of Exchange Vendors (with vendor contract data).

Make sure your team has the best intelligence available on the dynamic changes ahead and their impact. Order today!

Also Available on CD

The CD version of AIS’s Health Insurance Exchange Directory and Factbook includes all of the information in the printed book and more. It contains mailing lists in Excel spreadsheets with full contact information for professionals from public and private exchanges, as well as health plan exchange strategists and vendors providing all types of services that go into implementing exchanges. As an added benefit, this list includes email addresses where available.

The CD is also a convenient resource of premium rates for plans offered on exchanges. In addition to all released rates for all ages, AIS has created exclusive spreadsheets for 40-year-old nonsmoker individual and SHOP rates, by region, for all states that have released rates as of Sept. 30. It also includes additional spreadsheets on Essential Health Benefit plans and grants awarded to public exchanges, as well as conveniently grouped PDFs of all federal regulations and guidance on exchange implementation.

Table of Contents

Book Version Table of Contents

Introduction to Exchanges

Chapter 1: The Road to Implementation

  • Regulations, Guidance and Controversies
    • Individual Mandate
    • Employer Mandate
    • Medicaid Expansion
    • Guidance on Partnerships and Federally Facilitated Exchanges
    • Funding and Budget Issues
    • Rate-Review Thresholds
    • Multi-State Plans
  • Calendar of Exchange-Related ACA Implementation Milestones, Deadlines and Regulatory Releases
  • Delays and Contingencies
  • Insurance Industry Input and Legislative Initiatives
  • Pre-Existing Condition Insurance Plans and Results

Chapter 2: Technological Infrastructure and Human Resources

  • Implementation Resources and Challenges
  • Federal Data Services Hub
  • All-Payer Claims Databases
  • Vendor Challenges and Selections
  • IT Challenges for Payers
  • Exchange Staffing Requirements and Plans
  • Eligibility Verification
  • Security Concerns and HHS Guidance

Chapter 3: Consumer Support Tools and Resources

  • Decision-Support Tools
  • Navigators and In-Person Assistants
  • Virtual Assistants

Chapter 4: Essential Health Benefits

  • Regulations and Reactions
  • Benchmark Plan Criteria and Selection Process
  • Essential Health Benefit Benchmark Plans
  • Potential Impact on Premiums
  • Ancillary Products/Specialty Benefits

Chapter 5: State-by-State Exchange Strategies and Decisions

  • State-Level Exchange Evolution Process

Chapter 6: Federally Facilitated Exchanges

  • Application Design
  • Federal Subsidies/Premium Tax Credit
  • State Communications and Data Flow
  • Administration Progress Reports

Chapter 7: Exchange Marketing Initiatives and Responsibilities

  • Public Education Efforts
  • Outreach to Uninsured
  • Advertising Controversies
  • Partnerships, Outsourcing and Web-Based Entities

Chapter 8: Insurer Perspectives on Public Exchanges

  • Preparation Time Crunch
  • Carrier Participation Decisions
  • QHP Accreditation and Certification
  • Operating Costs and User Fees
  • Adverse Selection and Risk Corridors
  • Premium Rates and Profits
  • CO-OPs and Competition
  • Market Protection Rules

Chapter 9: Benefit Design in the Exchange Era

  • Defined-Contribution Plan Designs
  • Actuarial Value and Metal Tiers
  • Narrow Networks and Other Network Design Strategies
  • High-Deductible Health Plans

Chapter 10: Pharmacy Benefits and Exchanges

  • Essential Health Benefits for Pharmacy
  • State Benchmark Plans for Drug Benefits
  • Health Plan Strategies for Pharmacy Benefit
  • PBM Opportunities and Initiatives

Chapter 11: Selling Products on Exchanges

  • Branding and Rebranding
  • Marketing to Consumers
  • Market Studies on Consumer Behavior

Chapter 12: Challenges and Opportunities for Employers

  • Employer Mandate in ACA
  • Self-Insuring: Yes or No
  • Stop-Loss Insurance
  • SHOP Initiatives in Public Exchanges
  • Union Initiatives and Taft-Hartley Plans

Chapter 13: Private Exchange Models

  • Impact on Private Insurance Market
  • Multi-Carrier and Single-Carrier Exchanges
  • Multi-Carrier Private Exchanges
  • Single-Carrier Private Exchanges

Chapter 14: Market Impact of Exchange Proliferation

  • Caveats and Concerns of Stakeholders
  • Churn and Medicaid
  • Impact on Private Insurance Market
  • Impact on Insurance Agents and Brokers
  • Impact on Business and Labor Market

Chapter 15: Directories of Exchanges

  • Directory of Public Exchanges
  • Directory of Private Exchanges, by Organization

Chapter 16: Directories of Exchange Professionals, Appointees and Experts

  • Directory of Center for Consumer Information and Insurance Oversight Personnel
  • Regional Administrators for the Center for Consumer Information and Insurance Oversight
  • Directory of State Insurance Commissioners
  • State Exchange Board Members
  • Directory of Professionals in the Exchange Industry

Chapter 17: Directories of Exchange Vendors and Platforms

  • Directory of Exchange Vendors
  • Directory of Exchange Platform Providers

Appendix: Glossary of Terms

CD Version Table of Contents

  • Data on Public Exchange Participation by Carriers
  • State Exchanges Premium Rate Data — PDFs of original rate publications from states, as well as special spreadsheets of data entered for 40-year-old nonsmoker by region, by state, for individual and SHOP exchanges
  • Uninsured Eligibles by State
  • Monthly Pre-Existing Condition Insurance Plan Enrollment State-by-State
  • State Medicaid Expansion Status
  • State Establishment Grant Awards
  • Navigator Grant Awards
  • EHB Benchmark Plans
  • EHB Benchmark Plan Prescription Drug Coverage
  • Regulations and Guidances on Exchanges — full PDFs of government documents from HHS, CMS, OPM, and IRS
  • Sample Applications for FFEs
  • Directory of Public Exchanges
  • Directory of Private Exchanges
  • Directory of Exchange Vendors
  • Directory of CO-OPs
  • Directory of Exchange Experts
  • Directory of State Insurance Commissioners
  • Directory of Regional Administrators
  • Directory of State Exchange Board Members
  • Directory of CMS Exchange Personnel

Data Fields (CD)

Index of Charts (Book)

Written By

AIS’s Health Insurance Exchange Directory and Factbook is written and edited by the staff of Atlantic Information Services, Inc.

Written For

  • Health Plans
  • Hospitals and Health Systems
  • Physician Groups
  • Pharmaceutical Companies
  • State Health Policy Leaders
  • Attorneys, Consultants and Financial Analysts

AIS Guarantee

Order AIS’s Health Insurance Exchange Directory and Factbook for a 30-day risk-free inspection and test for yourself the value of this highly practical resource. If within 30 days you're not interested in keeping it, just return it to AIS and we will send you a prompt, full refund or credit. For CD purchasers, refunds will not be made once the seal on the CD package has been broken. Please review your copy of the print version prior to breaking the seal.

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View Sample (PDF)

AIS’s Health Insurance Exchange Directory and Factbook

Place your order through our secure shopping cart

$385.00
$575.00