individual experience advisory group july 17, 2012
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Individual Experience Advisory Group
July 17, 2012
2
Agenda
• Welcome & Introductions
10 min• Policies
60 min– Display & Pricing of Supplemental Plans
• Public Forum
10 min• Wrap-up
10 min
3
Supplemental Plans
• Definitions
– Embedded Plans There is a single premium and the consumer must purchase all of the benefits together
– Bundled PlanThe consumer may be charged a single premium but the plan has a separate premium for each component/policy
– Stand Alone PlanA plan that contains only a small subset of benefits like dental coverage
– Supplemental BenefitsBenefits that are not included in the EHB – adult dental, adult vision, various employer benefit options
– Supplemental PlanA plan that contains only supplemental benefits
4
Pediatric Dental
Per HHS Regulations – Pediatric Dental
must be included as part of the Essential
Health Benefits– May be embedded– May be bundled– If there is a standalone dental plan, only a
stand alone medical plan may be offered
EmbeddedSingle $
Bundled $ Medical
Stand Alone Medical$ Medical
$ Dental Stand Alone Dental$ Dental
5
Supplement Benefits Options
• Allow Supplemental Benefits to be embedded
• Allow Supplemental Benefits to be sold as stand alone plans
• Allow Supplemental Benefits to be bundled into a medical policy
and a supplemental policy(s)(may have a lower price)
6
Topic Summary & Board Target Decision Dates
Standard Comparative Plan Information 6/25
Display & Pricing of Supplemental Plans 7/23
Single Streamlined Application Aug
Navigator & Compensation Model Aug
Customer Service Center Aug/Sept
Consumer Rights & Responsibilities Aug/Sept
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