Information for Insurers

 

 

General Information

General Information

On this website your will find updates about the Affordable Care Act (Public Laws 111-148 & 111-152) and what it means for the insurance industry. Please check back often for ongoing updates.

Contact Information: For questions or comments, please contact us at L&Hinbox@ncdoi.gov or 919-807-6055, and ask to speak to someone regarding federal health care reform.

For information about federal CCIIO trainings, register at: https://www.regtap.info

Rate Filing Information

Rate Filing Information

Advisory Memorandum:

Rate Filing Information (Non-Grandfathered ACA-Compliant Plans Only)

NC Data Template*:

Checklists

Actuarial Memoranda:

Federal Unified Rate Review Template

Final Data Consistency

Geographic Rating Areas:

On Friday, March 29, 2013 NCDOI received approval of the REVISED geographic rating area request which included 16 rating areas for the State.

Contact Information: For questions or comments, please contact us at L&Hinbox@ncdoi.gov or 919-807-6055, and ask to speak to someone regarding Federal health care reform.

Form Filing Information

Form Filing Information

NC EHB Crosswalks:

For ALL Plan Year Non-grandfathered ACA-compliant plans from Plan Year 2017 and forward

Contact Information: For questions or comments, please contact us at L&Hinbox@ncdoi.gov or 919-807-6055, and ask to speak to someone regarding Federal health care reform.

Essential Health Benefits - Actuarial Value

Essential Health Benefits - Actuarial Value

Essential Health Benefits and Actuarial Value

Current NC Plan Year EHB Benchmark Information:

Supplemental Pediatric Dental and Vision Benchmarks:

 

Federal Actuarial Value Calculator:

2014-2016 EHB Benchmark Information - HISTORICAL:

Student Health Insurance

Student Health Insurance

Student Health Insurance Regulatory Filings Information (Non-grandfathered Plans Only)

Contact Information: For questions or comments, please contact us at L&Hinbox@ncdoi.gov or 919-807-6055, and ask to speak to someone regarding Federal health care reform.

Non-Grandfathered Transitional Coverage Information

Non-Grandfathered Transitional Coverage Information

Non-Grandfathered Transitional Coverage Information

Federal Exchange Information

Federal Exchange Information

Federally Facilitated Marketplace/SHOP Information

Pursuant to Session Law 2013-5, North Carolina will have a federally-facilitated marketplace (FFM) in 2015.

Below are links to resources for insurers related to applying to be a Qualified Health Plan (QHP) or exchange-certified Stand Alone Dental Plan (SADP) in the federal exchange for 2015:

The federal exchange has also set up a helpdesk for insurers which can be accessed by phone at 855-CMS-1515 or by email at CMS_FEPS@CMS.HHS.GOV.