Exchange

CVS Health is an Active and Strong Participant in Today’s Exchange Market.

Supporting 5.8M lives across 43 states, the individual exchange market remains strong with both competition and enrollment increasing as the federal marketplace is currently in a special enrollment period through the end of May 2021. Most insurers are entering into or expanding their service areas, while the number of states offering just a single plan decreased from 25 to 10 percent as plan participation increased in 13 of the federal marketplace states for 2021.https://www.cms.gov/CCIIO/Resources/Data-Resources/Downloads/2021QHPPremiumsChoiceReport.pdf https://www.kff.org/other/state-indicator/number-of-issuers-participating-in-the-individual-health-insurance-marketplace/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Number%20of%20Issuers%20in%202021%22,%22sort%22:%22desc%22%7Dhttps://360.avalere.com/state-policy-360/slides In addition, the federal government has committed to spending $50M in marketing and outreach for the special enrollment period, present date through May, 2021.

  • Premiums have decreased for the third consecutive yearhttps://www.kff.org/private-insurance/issue-brief/how-aca-marketplace-premiums-are-changing-by-county-in-2021/
  • E2021 open enrollment final data is expected to be higher by approximately 500,000 liveshttps://www.kff.org/policy-watch/what-to-expect-during-the-covid-marketplace-enrollment-period/
  • Five states have their own individual mandates and some states are moving off of the federal platform onto their own state-based exchange operating modelhttps://360.avalere.com/state-policy-360/slideshttps://www.kff.org/health-reform/state-indicator/state-health-insurance-marketplace-types/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D

We have the resources and agility to respond to marketplace demands and changes.

Established marketplace infrastructure
  • Resources and agility to respond to marketplace demands and changes
  • Marketing support to help attract and retain members
  • Solutions to help prevent and manage fraud, waste, and abuse
Strategic planning and cost management
  • Consultative support to help you implement the right strategy for your plan
  • Bid Advisor package to support your filing and rate development for exchange plans
  • Targeted programs to support marketplace quality ratings while lowering costs
Proactive regulatory and compliance support
  • Regulatory experts with state-specific experience
  • Compliance monitoring, support, and consultation on how to meet requirements
  • Monitoring and evaluation of new regulatory requirements
Established marketplace infrastructure
  • Resources and agility to respond to marketplace demands and changes
  • Marketing support to help attract and retain members
  • Solutions to help prevent and manage fraud, waste, and abuse
Strategic planning and cost management
  • Consultative support to help you implement the right strategy for your plan
  • Bid Advisor package to support your filing and rate development for exchange plans
  • Targeted programs to support marketplace quality ratings while lowering costs
Proactive regulatory and compliance support
  • Regulatory experts with state-specific experience
  • Compliance monitoring, support, and consultation on how to meet requirements
  • Monitoring and evaluation of new regulatory requirements

Have questions about expanding your Marketplace Exchange program? Ask Us.

Data source, unless noted otherwise, CVS Health Enterprise Analytics, 2021.

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