While most of us are trying to enjoy the last few days of summer before a very busy fall of Affordable Care Act implementation, insurance commissioners around the country continued their work at the summer 2013 meeting of the National Association of Insurance Commissioners (NAIC). This meeting brought state regulators together with consumer representatives, other policymakers and industry lobbyists to discuss numerous insurance issues, including ACA implementation in the states. While there were fewer fireworks than previous meetings, a lot of promising work is happening.
Many of the sessions at this NAIC meeting marked a shift in the role of commissioners. After months of reviewing health plan standards, rates and benefits, commissioners are keenly aware that consumers will soon purchase these plans. This means regulators are beginning to think more about oversight and enforcement, as well as educating consumers about the changes to the insurance market.
Getting information out
At one session, a number of state regulators discussed plans for providing information on new health insurance products. In particular, Kansas is creating an interactive website to help consumers understand what changes are coming in the next few months. They are also putting information about insurance rates online, doing roadshows around the state and working with Navigators to get materials out to consumers.
In addition, the Consumer Information working group brought together regulators, consumer groups and insurers to develop factual, unbiased FAQs to help insurance department staff in states around the country answer questions about the ACA. These FAQs are expected to be released soon.
Working to enforce the rules
One of the strongest tools insurance regulators have in oversight of health plans is formal review of complaints on insurers, called market conduct exams. Regulators often use consumer complaints to determine trends that are problematic either throughout an insurance market or with a particular insurance carrier. Because the ACA creates more rules for insurers to follow on providing benefits and access to coverage, commissioners and their staff now have many additional practices to monitor.
The NAIC Market Conduct task force is addressing this issue by updating the practices for regulators to track complaints and the standards to monitor insurers for any misconduct. While this process will take a few months, consumer representatives are at the table to ensure the right data will be collected to ensure individuals and families can adequately access health benefits.
While there were positive steps forward in a number of areas at the meeting, commissioners continue to ask questions about Navigators. Although the NAIC has previously drafted two white papers regarding the role of Navigators, a new white paper was proposed and moved forward at this meeting to again clarify the issue and incorporate developments from the final Navigator regulations. This document would focus on adequate training and marketing, privacy concerns, and suggestions for addressing fraud (people misrepresenting themselves as Navigators) in one central guidance to help commissioners move forward in their states. Consumer representatives believe these topics have already been clarified in numerous other places, including CMS regulations and Navigator Standard Operating Procedures. We will continue to monitor this paper as it is drafted.
Overall, the meeting was a snapshot of the many activities commissioners find themselves working on to implement the ACA. Stay tuned for more information in these areas, as oversight and monitoring of health insurance becomes more critical in the next few months.