Insurance Legal News: September/October 2011 • Volume 4, Number 5


In this issue:

Health Insurance Exchange Framework Beginning to Take Shape; State-Based Surplus Lines Insurance Reform Faces Uncertain Future; Sixth Circuit Holds Private Provider Need Not Demonstrate Responsibility of group Health Plan Prior to Suit Under the Medicare Secondary Payer Act; Michigan Court of Appeals Holds Consent Clause in Underinsured Motorist Policy Must Be Specifically Enforced and Precludes Collateral Estoppel Against the Insurer; and Third Circuit Recognizes State Law Claim for Deepening Insolvency.

Excerpt from 'Health Insurance Exchange Framework...':

A key part of expanding access to health insurance coverage under the Patient Protection and Affordable Care Act (“PPACA”) is the establishment of state-level “exchanges” where individuals and small employers will be able to purchase health insurance coverage effective January 1, 2014. The Department of Health and Human Services (“HHS”) has issued two sets of proposed regulations which begin to establish the framework for the creation and operation of the exchanges.

The first set of proposed regulations, issued on July 11, 2011, (1) sets out federal requirements that states must meet if they elect to establish and operate an exchange, and (2) outlines minimum requirements that health insurance issuers must meet to participate in an exchange and offer qualified health plans.

Please see full publication below for more information.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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