Regulatory Advisory

HHS, OPM Release Regulations on Insurance Reforms and Exchanges
CHA is reviewing to determine impact, if any, on Covered California

Both the U.S. Office of Personnel Management (OPM) and the Department of Health and Human Services (HHS) have released regulations related to health insurance reforms and benefit exchanges under the Affordable Care Act (ACA). HHS issued a final rule and interim final rule offering details for the risk adjustment, reinsurance, and risk corridors programs; cost-sharing reductions; user fees for federally facilitated exchanges; advance payments of the premium tax credit; the federally facilitated Small Business Health Option Program (SHOP); and the medical loss ratio program. HHS also has released a proposed rule implementing provisions of the ACA related to SHOP, while OPM has issued a final rule establishing the Multi-State Plan Program. CHA is currently reviewing the regulations to determine what effect, if any, they will have on Covered California. The proposed and final rules are attached.