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