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Michigan will Pursue Federal Partnership for its Health Insurance Exchange

federal partnership for health insurance exchangeAt the end of August, Governor Rick Snyder announced that Michigan will be pursuing a federal-state partnership for its health insurance exchange.  Health insurance exchanges are a requirement of the federal Health Care Reform law.  Health insurance exchanges are designed to  facilitate the purchase of health insurance by consumers through an online, cost-competitive forum.  Each state has the option to: (1) operate its own health insurance exchange; (2) partner with the federal government; or (3) allow the federal government to manage its health insurance exchange.

Michigan’s prior intention was to create a solely state-run exchange.  Last year, the Michigan Senate introduced a bill proposing a state-run exchange.  (For a detailed discussion of this bill, please review our prior newsletter article.)  However, a number of obstacles, including inaction in the Michigan House of Representatives and an impending November 16, 2012 deadline for submission of a state-exchange blueprint, made that goal unattainable at the present time.

The decision to operate under a partnership model means that the federal government will remain accountable for maintaining exchange functionality and ensuring that the exchange meets all required standards.

However, under the federal-state partnership model for health insurance exchanges, Michigan will still have control over a number of features of its exchange and it may choose to operate plan management functions.  Such plan management functions include:  plan selection; collection and analysis of plan rate and benefit package information; ongoing issuer account management; and plan monitoring, oversight, data collection and quality analysis.  The federal government under the federal-state partnership model would facilitate the exchange’s eligibility and enrollment functions as well as coordinate oversight of consumer complaints and enrollment reconciliation issues.

Under this model, Michigan may also choose to operate certain consumer assistance functions.  Such functions may include:  in-person assistance; navigator management; and outreach and education.  The federal government, however, would operate consumer assistance functions related to call center operations; website management; and written correspondence with consumers to support eligibility and enrollment.

Even though Michigan has chosen to pursue a state-federal partnership model for its exchange at this time, it may still convert to a solely, state-run model in the future.  For more information about Michigan’s efforts in implementing its health insurance exchange, please contact Mindi Johnson at (616) 726-2252 or by using the form below.

Categories: Employee Benefits, Health Care Reform, Health Insurance Exchange, Insurance, Regulatory

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With a business-minded approach, and service-oriented delivery, Mindi helps clients navigate challenges and solve problems in the areas of employee benefits law and health care law. Mindi has spoken and written extensively on employee benefits, health care reform, and health care law topics, and is actively involved in a number of legal, professional and industry organizations focused on these issues.

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Best Lawyers® 2021

Congratulations to the attorneys of the Health Care practice group at Foster Swift Collins & Smith, PC for their inclusion in the Best Lawyers in America 2021 edition. Firm-wide, 44 lawyers were listed. Best Lawyers lists are compiled based on an exhaustive peer-review evaluation and as lawyers are not required or allowed to pay a fee to be listed; inclusion in Best Lawyers is considered a singular honor. Health Care practice group members listed in Best Lawyers are as follows:

To see the full list of Foster Swift attorneys listed in Best Lawyers 2021, click here.