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Health Care Reform

Market Reform Technical Advisory Group

 

Issue Briefs  [return to top]

 

Meeting Materials  [return to top]

Rating Workgroup:
Essential Community Provider Workgroup:
TAG #12 - Market Analysis
TAG #11 - Federal Regulation Overview and Considerations
TAG #10 - Workgroup Findings
TAG #9 - Agent/Broker Issues Continued, Tobacco Rating Issues
TAG #8 - Health Insurance Agent/Broker Issues
TAG #7 - Initiation of Phase 2 and Select Certification Requirement Issues
TAG #6 - Essential Health Benefits Issues
TAG #5 - Market Competition Issues and re-visitation of Risk Adjustment and Reinsurance
TAG #4 - Rating Areas and Adverse Selection Mitigation
TAG #3 - Risk Adjustment and Reinsurance Programs
TAG #2 - - Small Group Issues
TAG #1 – Kickoff Meeting

 

About the TAG  [return to top]

The TAG is comprised of representatives of insurers, agents, academia, hospitals, providers, business and consumers who reside in North Carolina and have knowledge of North Carolina’s health care system and marketplace. The TAG considers and makes recommendations on each issue after a review of applicable State and federal laws, relevant literature, national stakeholder recommendations, and pending or passed legislation in other states.

The TAG evaluates the market reform policy options under consideration by assessing the extent to which they: expand coverage; improve affordability of coverage; provide high-value coverage options in the Exchange; empower consumers to make informed choices; support predictability for market stakeholders, competition among plans and long-term sustainability of the Exchange; support innovations in benefit design, payment and care delivery that can control costs and improve the quality of care; and facilitate improved health outcomes for North Carolinians. The TAG acknowledges that tension exists between these values and seeks to provide policy recommendations that are best aligned with the overall public interest, while ensuring the continued strength and viability of the State marketplace.

The purpose of the TAG is to develop options and considerations and to identify areas of consensus to inform the recommendations to the North Carolina General Assembly (NCGA) on ACA-related market reforms. The TAG was convened pursuant to North Carolina Session Law 2011-391, which authorized the Commissioner of Insurance to study insurance-related provisions of the ACA and any other matters it deems necessary to successful compliance with the provisions of the ACA and related regulations.

 

Legislative Authority  [return to top]

"It is the intent of the General Assembly to establish and operate a State-based health benefits Exchange that meets the requirements of the [ACA]...The DOI and DHHS may collaborate and plan in furtherance of the requirements of the ACA...The Commissioner of Insurance may also study insurance-related provisions of the ACA and any other matters it deems necessary to successful compliance with the provisions of the ACA and related regulations. The Commissioner shall submit a report to the...General Assembly containing recommendations resulting from the study."

-- Session Law 2011-391

If you have questions or comments about the TAG, please email L&Hinbox@ncdoi.gov