Health Insurance Exchanges: Product Design, Promotion and Positioning
Features insights from key industry consultants, state regulators and health insurers on the primary factors that will affect product designs for state health insurance exchanges. This valuable report also includes strategies for promoting exchange benefit offerings to individual and small-group customers, and planning for operational costs and challenges to exchange participation.
Health insurance exchanges may be the boldest experiment in the history of managed care. As many as 20 million people are expected to find coverage through the new state-based and federally operated marketplaces.
Health Insurance Exchanges: Product Design, Promotion and Positioning features insights from key industry consultants, state regulators and health insurers on the primary issues that will affect product designs for state health insurance exchanges.
With details on the federal government’s requirements for essential health benefits, and examples of premium rates and benefit designs already unveiled by some states, Health Insurance Exchanges: Product Design, Promotion and Positioning provides a comprehensive overview of this new health insurance marketplace.
The report also outlines the factors that are driving carriers’ decisions to participate in exchanges, and includes strategies that will help you plan for operational costs and challenges to exchange participation — such as enrollment and billing hurdles. Plus, results from market studies of consumer attitudes shed light on how to promote exchange benefit offerings to individual and small-group customers.
There is a tremendous amount riding on the success of exchanges. Make sure you’re prepared! Order Health Insurance Exchanges: Product Design, Promotion and Positioning today.
Table of Contents
Exchange Participation Decisions and Factors
- When It Comes to Participation in State Exchanges, Carriers Are Being Selective
- Exchange Participation? Milliman Outlines Key Issues for Insurers
- Arkansas’ Medicaid Expansion Compromise Could Entice Out-of-State Health Insurers 3
- For QHP Certification, Some States Go Beyond ACA Rules
- Large Insurers View Exchanges Cautiously; Illinois Attracts Fewer Plans Than Expected
- Colo., Ga., Md., Minn., N.H., R.I. Release Exchange-Offerings Details
- States Release More Details of Offerings on Insurance Exchanges
Coverage Requirements and Essential Health Benefits
- Calif. Exchange Unveils Benefit Design, Which Has High Copays
- Final Rule Released on Essential Benefits Keeps State Flexibility, Lacks Surprises
- Feds Offer Some Insight Into FFE and Partnership Functionality
Ancillary Benefits in Exchanges
- HHS Clarifies Its ‘Vision’ for Ancillary Products on Exchanges
- Consumers Can Sidestep Pediatric Dental Requirement in Exchange, but Not Outside
- Narrow Networks: HMO Redux or Effective Rate-Reducing Strategy?
- Insurers Eye Narrow Networks in Exchanges as Way to Lower Costs, Attract Members
- Narrow Network Model Not Appropriate for All Markets
- ‘Essential Community Providers’ Challenge Network Development
Risk and Actuarial Value
- Unknown Risk of Exchange Enrollees Could Force Carriers To Price QHPs Conservatively
- Actuaries Question Accuracy of HHS’s Planned Approach to Define Actuarial Value
- Final ‘3Rs’ Rule Allows Plans to Calculate Their Own Risk Scores
- ‘3Rs’ Interim Final Rule Yields New Details, Few Major Changes
- AV Calculator’s National Data Might Not Reflect Local Costs
Premiums and Rate-Setting
- Premium Hikes Are Seen as Likely for Individual Health Coverage
- Cost to Run Insurance Exchanges Could Bump Premiums by $6 to $22 Per Month
- Premiums Could Be Higher in States Not Expanding Medicaid
- Public Gets First Peek of Premium Rates in Md., Ore.; Others Are Expected Soon
- Premiums on Calif. Exchange Are Lower Than Expected, but Some Still Eye ‘Shock’
- CO-OPs Report Competitive Premiums, but Face Challenges
Positioning and Promotion
- Medicaid Firms Could Have Advantage in Exchanges; Deals Are Expected to Heat Up
- Good News for Small Carriers: Exchanges Could ‘Dilute’ Brand
- Blues Assn. Plans National Ad Campaign in Advance of Exchanges
- Carriers Gear Up for Exchanges by Retooling Products and Their Images
- The $23 Billion Question: Can Insurers Learn to Market to Consumers by October?
- Young, Invincible…Exasperated: Carriers Must Clear Confusion to Win Generation Y
- Enroll America Gears Up for National Outreach Effort, Will Add Hundreds of Staff
Market Studies, Estimates and Predictions
- CMS Divides Uninsured Into ‘Psychographic’ Segments
- Aon Hewitt: Majority of Exchange Enrollees Picked Cheaper Plan
- Survey: Unhappy Insured Members Are Eyeing Public Exchanges
- Consumers Expect Exchanges to Be Helpful
- Most CO-OPs Are Now Licensed, but Can They Compete With Established Carriers?
- Federal Premium Subsidies Could Mean Big Enrollment Gains for Medicaid Companies
- On the Inside Looking Out: Exchanges Might Fuel Robust Market on the Outside
- Little Attention Is Being Paid to SHOP, but Exchanges May Be Critical
- Most States Will Allow SHOP-ing, Higher Rates for Tobacco Users
- HHS Confirms SHOP Feature Delay in Final Rule
Brokers and WBEs
- Brokers Are Seen as Critical to Success of Exchanges, but Their Role Will Change
- Connecticut Brokers Will Be Paid by Plans
- Oregon to Charge Carriers Up to 5% Fee; Intends to Pay Brokers Directly
- Private Exchanges and WBEs Say They Can Drive More Enrollment to State Exchanges
- Brokers Have ‘High Level of Concern’ Over ACA, Survey Finds
- CMS Rule: Web Brokers Must Display QHPs, but Not Necessarily All Plan Information
Enrollment, Billing and Collections
- Think Enrollment Will Be Ugly? Just Wait Till It’s Time to Collect
- Will Exchange Application Process Be a Roadblock or Speed Bump for Consumers?
- Complexities in Billing Could Cause Plans to Lose Millions of Dollars
- Insurers Face ‘Herculean’ Task of Building Eligibility, Billing IT Systems by October
- CMS Whittles 21-Page Application Down to Three
- HHS Continues July Fireworks Display With Final Rule on Subsidy Eligibility Verification
This book was written by the editorial staff of AIS.
- Health Plans
- Hospitals and Health Systems
- Physician Groups
- Pharmaceutical Companies
- State Health Policy Leaders
- Attorneys, Consultants and Financial Analysts
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Health Insurance Exchanges: Product Design, Promotion and Positioning