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Background on Arizona Insurance Exchange
Summary:
 
The State of Arizona has a Federal-facilitated Marketplace.

The Federally-facilitated Marketplace is administered by the federal government, under the Department of Health and Human Services (HHS).
 
 
The state’s chosen benchmark plan is State of AZ Self-Insured Plan (Administered by United Healthcare).
 
Background:
 
The Affordable Care Act law requires that a State Insurance Exchange (Marketplace) be formed by each State to allow individuals and small businesses without health insurance to purchase it.
 
The ACA gave states the option of creating their own Exchange, allowing the federal government to create an Exchange, or creating an exchange through a Federal-State Partnership.
 
In states that have a federally-facilitated exchange, like Arizona, a single health plan was designated to serve as a benchmark for all other plans offered in the state. This plan serves as the standard health plan to determine Essential Health Benefits (EHBs) for all plans in the Exchange.
 
Below is information about the process by which Arizona made these determinations.
 
Developments:
  • The Office of Health Insurance Exchange was set up by Governor Jan Brewer (R) in order to “organize the health insurance marketplace for easier evaluation by individuals and small businesses to acquire affordable health insurance.
  • A bill to establish a state-run health insurance exchange currently remains pending in the house (HB 2783). In 2011 two similar bills were introduced but failed at the close of legislative session.
  • The Governor’s Office and legal counsel continue to research and consult on non-legislative options for establishing an exchange.
  • There are talks that Arizona is considering establishing an exchange as part of an existing state agency, such as the Governor’s Office, or creating a separate state agency within the Executive Branch.
  • A law was enacted on April 24, 2010 that prohibited plans in a state exchange from offering abortion coverage except in cases of life endangerment or sever health issues for the mother.
  • The Arizona Health Insurance Exchange Steering Committee was established to organize exchange-planning activities. Members of this committee include: Directors and senior staff from the Office of Health Insurance Exchange, the department of Insurance, the Arizona Health Care Cost Containment System, the Department of Economic Security, the Department of Health Services, and the Directors of Health Care Innovation Infrastructure Management.
  • Stakeholder feedback on exchange design and operational issues is gathered through an online survey (available through their website) and five work groups:
  • A health plans work group led by the Department of Insurance and focused on plan management requirements
  • A health brokers and agents group that focused on broker licensing and compensation
  • A tribal work group that focuses on developing outreach and education plans
  • An information technology infrastructure work group that is led by the Arizona Health Care Cost Containment System
  • A legislative work group
  • Arizona has expressed support for adoption a market facilitator approach where the exchange would then contract with all qualified health plans that meet the given criteria. The state has also started to evaluate their options on the design and implementation of risk adjustment, reinsurance, and risk corridor programs.
  • Arizona is upgrading their information technology using the “Enroll UX 2014” system.

 

Additional Background:
For More Information:
 

  

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