CMS-10320.Appendix_C_StateRequirements

Appendix C State Requirements
State Requests
While the primary source for information on product availability and costs are the
insurance issuers, there is a set of readily available state data which allows us to verify
the information obtained and assures that state regulatory authority is maintained.
Additionally, for the consumer to gain an adequate understanding of state context and
state resources we request that existing state sources of information be ascertained.
This data was requested from the states by May 21, 2010 in order to provide a source
against which vendor provided and issuer provided data may be compared.
A. Underwriting status: A statement of a state’s legal requirement for community rating, or allowance
for medical underwriting of insurance premiums.
B. Website address - state small group insurance: Those states which maintain a website providing
information and links for those seeking small group insurance, the Secretary will require this
information to provide to consumers. Additionally, States will provide a short description of the
conditions under which they want their site to be the primary point of entry for consumers and
why. This information is sought, both under the requirement for State consultation, but also for the
simple reason that some few states have regulatory conditions setting rates under different
conditions. In those cases, States may be able to provide more specific information than is
available from any other source.
C. Website address – individual insurance: Similar to small group markets, some states have
already created portal sites to direct consumers within their borders. We require that states which
have created such sites identify their location and inform the Secretary under what conditions
they would want to prioritize directing consumers to that site over directing them to issuers.
D. State registered small group Issuers: Obtaining a list of those registered by the state to offer small
insurance within their boundaries including contacts and an estimate of products offered is
essential for validating the claims of these issuers.
E. State registered individual Issuers: Obtaining a list of those registered by the state to offer
individual level insurance within their boundaries including contacts and an estimate of products
offered is essential for validating the claims of these issuers.
F. Contact Information: States will be asked to provide names, phone numbers and email addresses
for a primary and secondary contacts for initial data collection and for verification of information.