Health Insurance ExchangeHealth Insurance ExchangePlan ManagementPlan Management

Health Insurance ExchangeHealth Insurance ExchangePlan ManagementPlan Management

Exchange Plan Management, the Exchange Plan Management, the NAIC and SERFF:NAIC and SERFF:

Learning How the Pieces FitLearning How the Pieces Fit

Kelly McCumber, Product Specialist IIJon Sink, Business Analyst II

The NAIC, SERFF and Health Insurance The NAIC, SERFF and Health Insurance Exchange Plan ManagementExchange Plan Management

• Today’s Demonstration– Targeted towards Health Insurance Exchange

planners (non-insurance regulator)– NAIC background and support role for state

insurance regulators– SERFF’s role in Health Insurance Exchange Plan

Management

• Today’s Demonstration– Targeted towards Health Insurance Exchange

planners (non-insurance regulator)– NAIC background and support role for state

insurance regulators– SERFF’s role in Health Insurance Exchange Plan

Management

The NAIC, SERFF and Health Insurance The NAIC, SERFF and Health Insurance Exchange Plan ManagementExchange Plan Management

• Goals for today:– Explain to you how SERFF currently functions– Explain to you our ideas regarding how current

functionality can be used in Exchange Plan Management

– Review our high-level anticipated enhancements to accommodate Exchange Plan Management functionality

• Goals for today:– Explain to you how SERFF currently functions– Explain to you our ideas regarding how current

functionality can be used in Exchange Plan Management

– Review our high-level anticipated enhancements to accommodate Exchange Plan Management functionality

NAIC HistoryNAIC History

• The NAIC was established in 1871• The U.S. standard-setting and regulatory

support organization• Governed by chief insurance regulators from

50 states, D.C. and five U.S. territories

• The NAIC was established in 1871• The U.S. standard-setting and regulatory

support organization• Governed by chief insurance regulators from

50 states, D.C. and five U.S. territories

NAIC & State RegulatorsNAIC & State Regulators

• Establish standards and best practices• Conduct peer review• Coordinate regulatory oversight

• Establish standards and best practices• Conduct peer review• Coordinate regulatory oversight

NAIC OfficesNAIC Offices• New York (Securities Valuation Office)• District of Columbia (Executive Headquarters)• Kansas City (Central Office)-----------------------------------------------• All locations support the efforts of state

insurance regulators• Represent the collective views of state regulators • Form the national system of state-based

insurance regulation in the US

• New York (Securities Valuation Office)• District of Columbia (Executive Headquarters)• Kansas City (Central Office)-----------------------------------------------• All locations support the efforts of state

insurance regulators• Represent the collective views of state regulators • Form the national system of state-based

insurance regulation in the US

NAIC MembersNAIC Members

• Elected or appointed state government officials

• Regulate the conduct of insurance companies and agents

• Elected or appointed state government officials

• Regulate the conduct of insurance companies and agents

NAIC MissionNAIC Mission• Assist state insurance regulators, individually

and collectively in:– Serving the public interest– Promoting competitive markets– Consumer protection– Financial solvency of insurance institutions

• Assist state insurance regulators, individually and collectively in:– Serving the public interest– Promoting competitive markets– Consumer protection– Financial solvency of insurance institutions

NAIC SupportNAIC Support

• Work with the insurance commissioners and insurance department staff as they develop regulatory policy

• Provide numerous technology solutions to automate and streamline the regulatory process

• Work with the insurance commissioners and insurance department staff as they develop regulatory policy

• Provide numerous technology solutions to automate and streamline the regulatory process

Key Premises in Key Premises in Exchange DevelopmentExchange Development

• States will continue to regulate health insurance or play a key role in product review/approval and/or consumer assistance

• Exchange solutions should minimize the regulatory burden

• State insurance regulators wish to use existing information technology investments vs. building new ones

• States will continue to regulate health insurance or play a key role in product review/approval and/or consumer assistance

• Exchange solutions should minimize the regulatory burden

• State insurance regulators wish to use existing information technology investments vs. building new ones

NAIC’s Electronic SupportNAIC’s Electronic Support• 30 years of software development• Data repositories across all jurisdictions• The NAIC provides many tools to allow states

to make the most of their resources• Electronic processing for uniformity and

efficiency standards

• 30 years of software development• Data repositories across all jurisdictions• The NAIC provides many tools to allow states

to make the most of their resources• Electronic processing for uniformity and

efficiency standards

SERFF HistorySERFF History• A product of the NAIC• Developed in 1998• Key component in establishing uniformity and

speed-to-market in the insurance industry• Used by 51 state jurisdictions to review and

approve industry rate and form filings

• A product of the NAIC• Developed in 1998• Key component in establishing uniformity and

speed-to-market in the insurance industry• Used by 51 state jurisdictions to review and

approve industry rate and form filings

NAIC andNAIC andInsurance RegulationInsurance Regulation

• The NAIC has collective membership expertise in the individual and small group markets

• Uniquely positioned to have a key role in the major health care overhaul

• The NAIC has been a constant for over 140 years

• The NAIC support offices are a major contributor in the forum of health care reform

• The NAIC has collective membership expertise in the individual and small group markets

• Uniquely positioned to have a key role in the major health care overhaul

• The NAIC has been a constant for over 140 years

• The NAIC support offices are a major contributor in the forum of health care reform

NAIC andNAIC andHealth Care ReformHealth Care Reform

• More than two dozen mentions in the federal law

• 10 provisions give the NAIC responsibility or asks for assistance

• The NAIC’s efforts are recognized by the law and intended to be leveraged in order to bring about health care reform

• More than two dozen mentions in the federal law

• 10 provisions give the NAIC responsibility or asks for assistance

• The NAIC’s efforts are recognized by the law and intended to be leveraged in order to bring about health care reform

Health Insurance ExchangesHealth Insurance Exchanges

• Key component in health care reform• Expected to provide consumers better access

to health care choices• Requires the coordination of multiple state

and federal agencies

The reason we’re talking to YOU today!

• Key component in health care reform• Expected to provide consumers better access

to health care choices• Requires the coordination of multiple state

and federal agencies

The reason we’re talking to YOU today!

SERFF & Insurance Regulation SERFF & Insurance Regulation

• Used by insurance carriers and states since 1998

• Provides a single tool used by 49 states, DC and 1 territory

• Used by over 3,400 companies

• Used by insurance carriers and states since 1998

• Provides a single tool used by 49 states, DC and 1 territory

• Used by over 3,400 companies

SERFF & Insurance Regulation SERFF & Insurance Regulation

• Streamlines the filing and review process • Promotes speed-to-market and uniformity

throughout the industry• 27 jurisdictions mandate the use of SERFF for

all rate and form filings• Two million filings in the past 4 years

• Streamlines the filing and review process • Promotes speed-to-market and uniformity

throughout the industry• 27 jurisdictions mandate the use of SERFF for

all rate and form filings• Two million filings in the past 4 years

SERFF & Health Insurance Exchange SERFF & Health Insurance Exchange Plan ManagementPlan Management

We want to collect the correct contact information for individuals responsible for

Exchange development. If you received notice of this demo from someone else, please send your contact

information to jfranz@naic.org. You’ll be put on a list for future correspondence.

Thank you for attending!

We want to collect the correct contact information for individuals responsible for

Exchange development. If you received notice of this demo from someone else, please send your contact

information to jfranz@naic.org. You’ll be put on a list for future correspondence.

Thank you for attending!