NY exchange plans may have to include out-of-network benefits

New York officials are considering whether to require insurers provide out-of-network benefits on all plans sold on the state's health insurance exchange, reported Capital New York. But insurers are pushing back, saying the move could cripple one of the most successful marketplaces in the country. "We're proposing that our invitation [to insurers] will include an out-of-network requirement," Randi Imbriaco, a health department official, told industry stakeholders. However, the department hasn't yet confirmed exactly how the benefits will work, Imbriaco said, adding that officials are "open to suggestions as to what that network should be." If the state does require out-of-network reimbursements, insurers warn that premiums could increase by as much as 30 percent, Capital New York noted. What's more, insurance companies said the change could cause actuarial problems as they try to determine a premium structure that works for consumers and isn't too much of a liability for themselves. Article

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