Webinar: Standardized Benefit Plans: A Tool for Consumers?

In a recently proposed rule, the Centers for Medicaid and Medicare Services (CMS) is considering providing qualified health plans with the option of offering standardized benefit plans in the federally facilitated marketplace (FFM). CMS contemplates creating standardized plan options at the bronze, silver and gold levels and for every cost sharing tier in silver plans. These options would include a single provider tier, a four or five tier formulary, fixed deductibles for in-network services; fixed cost sharing limits, and would standardize copays and coinsurance levels for key services. Some services would be offered before the deductible is applied. The proposal to standardize plans “is intended to simplify the consumer shopping experience by allowing consumers to more easily compare plans across issuers in the individual market FFMs.” However, standardized plans can also be designed to improve patient access to care and in particular, drive adherence to prescribed therapies.
A number of state-based marketplaces have implemented standardized benefit design. For example, California’s marketplace adopted standardized plans across the bronze, silver, gold and platinum metal levels in order to “make it easier for enrollees to make an informed choice and choose the right plan for themselves and their families. New Jersey, a state using the federal exchange, has offered standardized plans in the individual and small employer markets since the early 1990s.
During this webinar, national experts and state panelists will:

• Describe standardized benefit design and the state of the art in implementing it
• Explore its value, opportunities and limitations
• Explore how states are using standardized plans and what additional value could be gleaned from them
• Focus on the implications of the new rule proposed by CMS
• Discuss how benefit design can impact the use of health care and out-of-pocket costs

Speakers:

• Moderator: Kevin Lucia, Georgetown University Health Policy Institute
• Heather Cloran, Associate Director of Programs & Product Strategy, Massachusetts Health Connector
• M. Christopher Roebuck, RxEconomics
• Ward Sanders, former Executive Director of the New Jersey Individual Health Coverage Program Board and New Jersey Small Employer Health Benefits Program Board, and current President, New Jersey Association of Health Plans
• JoAnn Volk, Georgetown University Health Policy Institute
• Sarabeth Zemel, Project Director, National Academy for State Health Policy

This webinar is presented with support from PhRMA