OPM Proposes Parameters for ACA Multi-State Insurance Exchanges

The Office of Personnel Management (OPM) published a proposed regulation on December 5, 2012 to establish rules for the ACA Multi-State Plan Program (MSPP). In order to promote competition and choice in the insurance marketplace, the ACA MSPP provisions require OPM to enter into contracts with private health insurance issuers to provide at least two multi-state plans (MSPs) to be offered on Exchanges. Among other things, the proposed rule addresses standards for: qualifications of issuers that seek to participate in the MSPP; the framework for OPM coordination with states and HHS with regard to rates, medical loss ratios, and the MSPP issuer’s participation in reinsurance, risk adjustment, and risk corridor programs; the application and contracting process; how OPM will monitor contract performance; and enrollee appeal standards. As authorized under the ACA, an MSPP issuer may phase in the states in which it offers coverage over four years according to a prescribed schedule, but it must offer MSPs on Exchanges in all states and the District of Columbia by the fourth year in which it participates in the MSPP. Comments will be accepted until January 4, 2013.

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