Since the passing of the Affordable Care Act (ACA), the health insurance industry has undergone monumental changes. After legislation passed requiring all health insurance policies be sold on a guaranteed issue basis, PAI was called upon by a number of states for advice, due in large part to our long-time involvement in the management of market stabilization mechanisms. Today, we are actively involved in the ACA’s Transitional Reinsurance Program.
Special individual programs we administer often require us to work closely with Exchange staff members or to be familiar with insurance plans sold on the Exchange. In order to ensure our program members fully understand the options available to them when purchasing health insurance, our customer service and account management teams work closely with exchange staff members to provide communications that clearly outline plan options available inside or outside of the exchange. A number of PAI staff members are also Certified Application Counselors (CAC) in Connecticut, which provides added value to our existing members and, as a part of our continuous training initiative, participate in training in order to remain up-to-date with their certification.
Additionally, our small employer reinsurance staff is called upon by the SHOP Exchange (Small Business Health Options Program) employees for guidance on the small employer reinsurance program in their state to ensure that they are meeting legislative requirements and adhering to the reinsurance reporting process. PAI employees are collaborative by nature and are known to be valuable and beneficial resources for information.
As these entities evolve, PAI continues to field inquiries on a variety of topics related to market stabilization, subsidy and reimbursement processing and administrative techniques.
For more information regarding PAI’s Health Insurance Marketplace solutions, please contact Nancy Doty