OHA has issued a “Consumer Assistance in Ohio’s Health Insurance Marketplace” whitepaper detailing the considerations hospitals and health systems need to make when deciding if and how they will provide assistance to consumers in the Marketplace. The whitepaper provides information about the various consumer assistance programs, identifies the options available to hospitals and health systems, and points out some of the legal and practical considerations related to each program.
Hospitals that desire to provide consumer assistance regarding health insurance options are permitted to do so. However, federal and state laws and regulations create parameters within which organizations must operate in order to provide such services. Hospitals are encouraged to consult with legal counsel as they decide whether or not to provide consumer assistance.
Also included in the whitepaper, the following resources may be helpful to hospitals in analyzing consumer assistance opportunities:
- Ohio HB 3 (effective July 30, 2013) – new Ohio law regarding Navigators
- Ohio Department of Insurance Regulations (expected to be effective on or about Sept.1, 2013) – new regulations regarding Navigators, including a “safe-harbor” for hospitals providing information to consumers
- Final Federal Regulations regarding Navigators and CACs (published July 17, 2013)
An additional resource hospitals may find helpful regarding the Health Insurance Marketplace is the Value Penguin webpage, which provides information on the health plans being offered on the Exchange, including premium rates and subsidy eligibility for individuals.