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| West Virginia State Insurance Exchange |
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Summary:
Current Status in Establishing Exchange:
State pursue partnership exchange.
Decision Process:
Executive branch.
Exchange Funding:
· The West Virginia Office of the Insurance Commissioner received a federal Exchange Planning grant of $1 million in September 2010 and a federal Level One Establishment grant of $9.7 million in August 2011. The Establishment grant will be used to study consumer quality and effectiveness, complete economic modeling, and investigate risk adjustment strategies and policy integration with state agencies. The state requested and received a No Cost Extension for the Establishment grant, in part due to the delay of the release of an RFP for an actuarial assessment and economic model of the Exchange.?
· The Exchange is authorized to assess fees on all health carriers selling qualified health benefit plans or dental plans, including those sold outside the Exchange. The fee amounts will be based on the plan’s premium volume and can be collected any time after July 1, 2011. Additional information about the fee amounts and manner of collection will be better defined in legislative rules. In July 2012, the OIC released a preliminary budget for the Exchange with various enrollment scenarios for operational years 2014 through 2016.
Benchmark Plan:
- Since the state did not determine a benchmark EHB plan West Virginia will default to the largest small-group plan in the state, High Mark (Blue Cross Blue Shield of West Virginia)- Super Blue Plus 2000 PPO.
Additional Information:
- Initially West Virginia intended to declare a state-based exchange, but after passage of such legislation, concerns arose over the state's ability to afford and maintain this option led them to seek a partnership.
- The federal government will assume full responsibility for running a health insurance exchange in West Virginia beginning in 2014, unless the state decides to operate either a state-based exchange or state-federal partnership exchange. If West Virginia opts for a state-based exchange, it must submit an exchange blueprint consisting of a declaration letter signed by the Governor and an application to the U.S. Department of Health and Human Services (HHS) by December 14, 2012. If, instead, the state opts for a partnership exchange, it must submit a blueprint by February 15, 2013.
For More Information:
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