Reinsurance Proposal 13

Reinsurance Reinsurance Coinsurance Legislation Waiver status

type corridor rate enacted

Alaska Condition- All claims from100%

policy-holdersHB
with
374one of 33 specific
Submitted
conditions
Dec.Approved
29, 2016 July 7, 2017
Comprehensive specific Nov. 7, 2016
Health Insurance reinsurance
Fund

Idaho Complex Condition- $25,000 – At least 20% S1150 1332 waiver 1115
Medical Needs specific April 6, 2017 released for waiver
Waiver Medicaid public released
eligibility, comment Nov. for public
condition- 1, 2017 comment
specific Nov. 22,
reinsurance 2017

Iowa Stopgap Traditional $100,000 – 85% / 15% No applicable state Submitted Submitted Amended
Measure (ISM) reinsurance $3,000,000 (Claims >$3 legislation June 12, 2017 Aug. 22, Sept. 22,
million: 2017 2017
100%)

Louisiana Health Traditional TBD TBD HB246 HB274 Waiver

Reinsurance reinsurance description
Association (LHRA) released April
2018

Maine Guaranteed Condition- Automatic ceding

90%for
/ 10
claims
% between
LD 659June
for 2,
covered
2017 Waiver
members
executive
withWaiver
one
summary
or submitted
more
Determined
and
of eight
actuarial
Mayconditions;
9,complete
2018
analysis volun
relea
June
Access Reinsurance specific (Claims
Association reinsurance >$77,000:
(MGARA) 100%)
Maryland Traditional TBD – 80% / 20% HB 1795 HB 1782 Draft waiver released
Submitted
AprilMay
20, 2018
31, 2018
Reinsurance reinsurance $250,000 April 5, April 10,
Program 2018 2018

Minnesota Traditional $50,000 – 80% / 20% HF 5 Submitted Approved Signed

Premium Security reinsurance $250,000 April 4, 2017 May 5, 2017 Sept. 22, Oct. 16,
Plan 2017 2017

New Hampshire Traditional $45,000 – 40% / 60% HB 469 Draft waiver Waiver not
1332 Waiver reinsurance $250,000 July 10, 2017 released for submitted
Reinsurance Plan public
comment July
19, 2017

New Jersey Health Traditional TBD TBD S1878May 30, 2018Draft waiver released May 31, 2018
Insurance Premium reinsurance
Security Plan

Oklahoma Traditional $15,000 – 80% / 20% HB 2406 Submitted Withdrawn

Individual Health reinsurance $400,000 June 6, 2017 Aug. 16, 2017 Sept. 29,
Insurance Market 2017
Stabilization
Program (OMSP)
Oregon Traditional TBD – 50% / 50% HB 2391 Submitted Approved Signed
Reinsurance reinsurance $1,000,000 July 5, 2017 Aug. 31, 2017 Oct. 19, Oct. 20,
Program (ORP) 2017 2017

Wisconsin Traditional $50,000 – 50% in 2019 SB 770 Draft waiver released

Submitted
March
April
Determined
13,18,
2018
2018complete May
Healthcare Stability reinsurance $250,000 (50% – 80% Feb. 27, 2018
Plan (WIHSP) required by
statute)

[i] Kaiser Family Foundation. “State Health Insurance Marketplace Types, 2017.” http://www.kff.org/health-reform/state-indicator/state-he

[ii] Expanded Medicaid September 1, 2015

[iii] Minnesota also has MinnesotaCare, the Basic Health Program (BHP) for individuals 138–200% FPL.

[iv] Expanded Medicaid with Section 1115 Waiver

 1332 State Innovation Waiver Individual Market

1332 funding Marketplace Type[i]

r status State funding Source of state funds 1332 funding request received

$55 million $55 million in initial $51.6 million in pass- $58.5 million (2018)
Federally-
$332 million (2018–2022)
annually (51.6% funding from General through funding facilitated
of total) Fund, then funded via (48.4% of total) Marketplace
assessments on all
insurers- Health: 6% of
premiums net of claims,
Title: 1% of gross
premiums, Other: 2.7% of
gross premiums

$16 million in Net losses of state $0 for reinsurance. $613 State-based

2019 for state- reinsurance pool funded million in 1332/1115 Marketplace
funded high risk by annually-determined waiver funding
pool assessment on insurers

Withdrawn $0 No state funding $70 million in pass- State-

Oct. 23, (0% of total) through funding for partnership
2017 reinsurance in 2018 Marketplace
(100% of total)
$396 million total
waiver funding in 2018

$24.8 million Per-member assessment $103.5 million in pass- Federally-

(17.2% of total) on all issuers, third-party through funding (82.8% facilitated
administrators, and of total) Marketplace
MEWAs doing business in
Louisiana. Assessment
rate TBD.

$59.6 million in Assessment on health $33.4 million in pass- Federally-

2019 (64.0% of insurers and third-party through funding in 2019 facilitated
total) administrators of $4 (36.0% of total) Marketplace
PMPM (Individual, Small
Group, Large Group, and
Self-insured markets);
90% of enrollee premium
for ceded members and
dependents
$365 million in 2.75% assessment on $97 million in pass- State-based
2019 (79.0% of Maryland health plans through funding in 2019 Marketplace
total) and Medicaid MCOs, (21.0% of total)
based on annual net
premiums
$271 million Dedicated funding from $138 – $167 million in $130.7 million (2018)
State-based
$1.003 billion (2018–2022)
annually (61.9% Health Care Access Fund annual pass-through Marketplace
– 66.3% of total) (financed via 2% provider funding, $830 million
assessment) and General 2018-2022) (33.7% –
Fund 38.1% of total)

$32 million Annually-determined $12.8 million in pass- Federally-

annually (71.4% assessment on health through funding for facilitated
of total) insurers per covered life, reinsurance (28.6% of Marketplace
necessary to fund total)
reinsurance pool

TBD Penalties from state TBD Federally-

individual coverage facilitated
mandate, general fund Marketplace

$16 million in Assessment on premiums $309 million in pass- Federally-

2018, $230 charged by all health through funding in 2018, facilitated
million over five insurers and reinsurers $1,395 million over five Marketplace
years (14.2% of years (85.8% of total)
total)
$90 million in 1.5% assessment on fully $35.66 million in 2018 $54.5 million (2018)
State-based
2018, $1.1 insured commercial major $356.6 million over 10 Marketplace
billion over 10 medical premiums years (31.5% to total) with Federal
years (68.5% of Platform
total)
$34 million in State general fund $166 million in pass- Federally-
2019 (17% of through funding in 2019 facilitated
total) (83% of total) Marketplace
Individual Market

Medicaid
Expansion
Status
Expanded Medicaid[ii]

Did not
expand
Medicaid

Expanded Medicaid[iv]

Expanded
Medicaid

Did not
expand
Medicaid
Expanded
Medicaid

Expanded Medicaid[iii] q

Expanded
Medicaid

Expanded
Medicaid

Did not
expand
Medicaid

Expanded
Medicaid

Did not
expand
Medicaid