NAIC Update

NADP attended the NAIC spring meeting hosted this month in Phoenix, AZ.

• The Network Adequacy Model
  Review (B) Subgroup Workgroup continues to slowly progress through the
  Managed Care Plan Network Adequacy Model Act (to be renamed.) Earlier in
  the month on a conference call, Chris Peterson (on behalf of Delta
  Dental Plan Association) proposed a change to the definition section of
  the model to exempt HIPAA excepted benefits. Montana’s legal counsel as
  well as a consumer advocate did not agree; NADP reiterated the multiple
  ‘rabbit holes’ that will emerge trying to exempt dental from multiple
  sections rather than make a definitional change. The chair of the
  working group requested the dental industry review the model act and a)
  determine which sections should exempt dental plans, b) whether a
  separate model act would be pertinent, or c) conclude whether changes
  may not be necessary or simply include a drafting note related to dental
  instructing insurance departments to carefully review the impact the
  model has on dental within their own state.

• The NAIC will start to review the Accident and Sickness Insurance Minimum Standards Act
  as well as the coordinated implementation standards to that model
  (model #170/#171). Dental and vision are included within these models.
  Comments on these model will be due in mid-June

NADP will be
convening a subgroup of interested members to review both the NAIC
Network Adequacy and NAIC Accident and Sickness models. The work will
take place over the spring.

• The NAIC Health (B) Committee discussed various options they had should Burwell v. King
  go against the government and subsidies are terminated for those states
  operating in Federally-facilitated Marketplaces. CCIIO also presented
  to NAIC reviewing the Benefit Payment and Parameter regulations as well
  as Marketplace timelines. The Commissioners stressed to the
  administration that any decision allowing states to delay the increase
  in definition of small employer size from 50 to 100 needs to happen NOW, not in weeks or months, and delay on their part could be catastrophic for the market.