CHOICE Administrators Exchange Solutions Issues Comprehensive Summary of CMS, HHS and Treasury Draft Regulations on

New White Paper Summarizes Multi-Page Document for State-Exchange Operations and Other Exchange-Related Guidelines

ORANGE, Calif.--(BUSINESS WIRE)-- As states across America scramble to fulfill the federal mandate to establish their own health insurance exchange by January 1, 2013, America’s leading developer of exchanges today issued a summary of federal draft regulations and other recently released guidelines concerning the establishment and operation of these exchanges. The 18-page summary report produced by CHOICE Administrators Exchange Solutions is intended to provide regulators, policymakers, brokers and other key stakeholders a quick resource for proposed health reform information.

One of the key documents summarized by CHOICE Administrators Exchange Solutions is a document issued this summer by the Centers for Medicare & Medicaid Services (CMS) which outlines in detail guidelines for affecting functionality, oversight, reinsurance, marketing and risk adjustment standards. “What we’ve done is create a synopsis of proposed regulations that state officials, consultants, brokers and others can access at,” said company President Kevin Counihan. “With so many moving parts and refined responsibilities on state exchanges, this summary is intended to be a helpful tool to aide stakeholders in understanding proposed regulations and prepare for compliance.”

The Patient Protection and Affordable Care Act requires all states and territories to establish their own state-run health insurance exchanges by January 1, 2013, or default to a federal exchange. By that date the U.S. Department of Health and Human Services will determine whether a state’s exchange is in compliance and may provide either “conditional” or “full approval” depending on progress toward meeting compliance.

The guidelines issued in July by CMS speak to two sets of proposed regulations: state exchange operations and oversight standards. CHOICE Administrators Exchange Solutions has synopsized this document into two sections — qualified health plan standards and risk adjustment, risk corridors, and reinsurance standards – and covers such areas as basic requirements for the establishment of an exchange, exchange functions, how individual enrollment will work and the required functions of the small business exchange. The CHOICE Administrators Exchange Solutions overview also highlights the proposed role of navigators in educating individuals about the responsibilities and opportunities of health reform, how carriers’ benefit plans will be certified to participate in an exchange, and how a sufficient number of “essential community providers” will be assured for each exchange.

In August of this year, CMS released additional draft regulations concerning state Medicaid and exchange eligibility determinations. On the same date, the U.S. Department of the Treasury released a notice of proposed rulemaking (NPRM) concerning the calculation and administration of premium tax credits in 2014 to make health insurance more affordable for lower- and middle-income citizens. The new CHOICE Administrators Exchange Solutions document includes sections that simplify these two additional sets of proposed regulations and cover such areas as determining exchange eligibility, basic rules for calculating tax credits and the impact on employer-sponsored insurance.

The CHOICE Administrators Exchange Solutions document is the latest in a long list of initiatives the company has undertaken to keep regulators, policymakers, brokers and other key stakeholders aware of changes brought about by healthcare reform and, specifically, the impact of health insurance exchanges. Over the past 18 months, CHOICE Administrators Exchange Solutions has published “An Employers’ Guide to Healthcare Reform” booklet, introduced a tax-credit calculator to help eligible small business owners access federal tax credits, published a guide explaining the benefits of a tax-advantaged Health Savings Accounts (HSAs), conducted a series of training programs for brokers concerning health insurance exchanges, and has spoken on health reform and exchanges at various national conferences including last month’s Health Care Reform Congress on Health Insurance Exchanges.

“As further health insurance exchange regulations are developed and proposed, we will continue to release summaries and other information that leads to a greater understanding of this important topic,” said Counihan. “We believe it is vital that those impacted most by exchanges stay informed of current developments and feel empowered to influence the changing marketplace.”

CHOICE Administrators Exchange Solutions is a division of CHOICE Administrators, the nation’s leader in developing and administering health insurance exchanges. It is part of The Word & Brown Companies, the nation’s leading developer and administrator of consumer-choice exchange models. Among the exchanges currently operated by CHOICE Administrators are the CaliforniaChoice® small group (2-50 employees) and mid-market (51-199 employees) private exchanges; HSA California; Choice Builder, the nation’s first ancillary benefit exchange; and Quotit, one of the nation’s largest individual/family proposal and online enrollment systems that generated nearly 50 million individual health quotes in 2010. Other CHOICE Administrators products include Kaiser Permanente Choice Solution and Contractors’ Choice. Further information is available at


For CHOICE Administrators Exchange Solutions
Ross Goldberg, 818-597-8453, x-1
[email protected]

KEYWORDS:   United States  North America  California

INDUSTRY KEYWORDS:   Health  Public Policy/Government  Healthcare Reform  Other Policy Issues  Public Policy  State/Local  White House/Federal Government  Professional Services  Insurance  General Health  Managed Care