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ACA Now

1103 - Immediate Information that Allows Consumers to Identify Affordable Coverage Options

 
Implementation Status 
Statutory Text 

Summary

Amended by section 10102 of the Manager’s Amendment. By July 1, 2010, requires that HHS establish a website so individuals and small business in States can identify and compare available health insurance options including individual and small group coverage, as well as Medicare, Medicaid and CHIP and high risk pools.

HHS must develop a standardized format for presenting information regarding coverage options including information related to medical loss ratio, eligibility, availability, premium rates and cost sharing. Effective March 23, 2010.

#Cost-Sharing, #Transparency

Implementation Status

 
Summary 
Statutory Text 

The Plan Finder is available on the www.healthcare.gov website.

For information on Plan Finder data, as the Web Portal now is known, see the CCIIO website.

2010

HHS published an interim final rule on May 5, 2010, implementing this provision, addressing the categories of information it will collect and display on the statutorily required website, which it references in the rule as the “Web Portal.”

2013

On March 28, 2013, CCIIO posted a Q&A regarding Plan Finder data entry, as well as a State User Manual, an Issuer User Manual, a HIOS Portal User Manual and a Rates and Benefits Information System User Manual.

On May 28, CCIIO released a Q&A for issuers regarding data entry into the Plan Finder.

2014

On April 11, CMS published an information collection notice (see #3 on p. 2) on the Health Care Reform Insurance Web Portal addressing quarterly updates to health insurance issuer information, as well as submission and verification procedures, among other details. Comments are due on May 12, 2014.

On Aug. 19, CCIIO released a user guide providing operational details on plans’ submission of product-level information for the ACA Plan Finder; submissions are made through the Health Insurance Oversight System using any of three specified formats.

In an Oct. 6, 2014, report, GAO used Plan Finder data from January 2013 – reflecting pre-underwriting, base-premiums in the individual market – to provide a pre-ACA baseline of pre-ACA premiums.

On Oct. 29, CCIIO posted a preliminary Excel file on the Plan Finder data homepage containing “data collected for display for Plan Finder in all of 2014.”

Statutory Text

 
Implementation Status 
Summary 

SEC. 1103 [42 U.S.C. 18003]. IMMEDIATE INFORMATION THAT ALLOWS
CONSUMERS TO IDENTIFY AFFORDABLE COVERAGE OPTIONS.
(a) INTERNET PORTAL TO AFFORDABLE COVERAGE OPTIONS.—
(1) IMMEDIATE ESTABLISHMENT.—[As revised by section
10102(b)(1)] Not later than July 1, 2010, the Secretary, in consultation
with the States, shall establish a mechanism, including
an Internet website, through which a resident of any, or
small business in, State may identify affordable health insurance
coverage options in that State.
(2) CONNECTING TO AFFORDABLE COVERAGE.—øReplaced by
section 10102(b)(2)¿ An Internet website established under
paragraph (1) shall, to the extent practicable, provide ways for
residents of, and small businesses in, any State to receive information
on at least the following coverage options:
(A) Health insurance coverage offered by health insurance
issuers, other than coverage that provides reimbursement
only for the treatment or mitigation of—
(i) a single disease or condition; or
(ii) an unreasonably limited set of diseases or conditions
(as determined by the Secretary).
(B) Medicaid coverage under title XIX of the Social Security
Act.
(C) Coverage under title XXI of the Social Security
Act.
(D) A State health benefits high risk pool, to the extent
that such high risk pool is offered in such State; and
(E) Coverage under a high risk pool under section
1101.
(F) Coverage within the small group market for small
businesses and their employees, including reinsurance for
early retirees under section 1102, tax credits available
under section 45R of the Internal Revenue Code of 1986
(as added by section 1421), and other information specifically
for small businesses regarding affordable health care
options.
(b) ENHANCING COMPARATIVE PURCHASING OPTIONS.—
(1) IN GENERAL.—Not later than 60 days after the date of
enactment of this Act, the Secretary shall develop a standardized
format to be used for the presentation of information relating
to the coverage options described in subsection (a)(2).
Such format shall, at a minimum, require the inclusion of information
on the percentage of total premium revenue expended
on nonclinical costs (as reported under section 2718(a)
of the Public Health Service Act), eligibility, availability, premium
rates, and cost sharing with respect to such coverage options
and be consistent with the standards adopted for the uniform
explanation of coverage as provided for in section 2715 of
the Public Health Service Act.
(2) USE OF FORMAT.—The Secretary shall utilize the format
developed under paragraph (1) in compiling information
concerning coverage options on the Internet website established
under subsection (a).
(c) AUTHORITY TO CONTRACT.—The Secretary may carry out
this section through contracts entered into with qualified entities.

Browse ACA Titles

  • I-Quality, Affordable Health Care for all Americans
  • II-Role of Public Programs
  • III-Improving the Quality and Efficiency of Health Care
  • IV-Prevention of Chronic Disease and Improving Public Health
  • V-Health Care Workforce
  • VI-Transparency and Program Integrity
  • VII-Improving Access to Innovative Medical Therapies
  • VIII-Community Living Assistance Services and Supports (CLASS ACT)
  • IX-Revenue Provisions

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