Not sure where to start in transitioning to a State-Based Marketplace? Below are some resources to help you start planning. Have questions? We’re here to help, just send us an email at firstname.lastname@example.org.
SBM Build-Out Timeline
There are critical activities that must be completed when looking to build a State-Based Marketplace. Below is a quick look at some of these. (Timeline content courtesy of Heather Korbulic, Executive Director, SSHIX.)
Shopping on State-Based Marketplaces
Want to check out the state exchanges anonymously? Try one of the scenarios below:
Takes one prescription medication:
- Prozac (brand name or generic)
One male, 55
Takes three prescription medications:
- Lipitor (brand name or generic)
- Prilosec (brand name or generic)
- Xiidra (only brand name available)
Governor Letters Requesting an SBM
Governors are required to send a letter to CMS noting their intention to transition to a state-based marketplace. These are the publicly available letters that can be used as a model for future state letters.
- Rhode Island (July 5, 2012)
- Vermont (July 9, 2012)
- California (July 10, 2012)
- Connecticut (July 10, 2012)
- Massachusetts (July 10, 2012)
- Washington (July 10, 2012)
- Colorado (October 8, 2012)
- Maryland (October 9, 2012)
- District of Columbia (November 15, 2012)
- Minnesota (November 15, 2012)
- New York (November 15, 2012)
- Idaho (December 14, 2012)
State-Based Marketplace Blueprint
A “Blueprint” is a document in which your state tells CMS a little about how you intend to build out and operate your exchange.
State-Based Exchange Cash Flow Illustration
The Affordable Care Act (ACA) & 1332 Waiver Guidance
Here you’ll find the actual text from the Patient Protection and Affordable Care Act (PPACA), which is often shortened to the Affordable Care Act (ACA). You can also find the latest guidance on how to utilize 1332 waivers.
- Affordable Care Act (Certified full-text version)
- Reconciliation Act (Certified full-text version)
- Section 1332 State Relief and Empowerment Waiver Concepts (November 2018)
State-Based Marketplace Requests for Information (RFI)
Thinking of putting out an RFI? Here are what other states have done.
- MNsure (Minnesota): Consumer Shopping, System of Record, Enrollment Decision Support, and Small Business Health Options Program Tools for MNsure (PDF)
- Silver State Health Insurance Exchange (Nevada): Integrated Online Health Insurance Exchange Platform and Associated Consumer Assistance Center
- beWellnm (New Mexico): Health Insurance Exchange Platform
- Oregon Health Insurance Marketplace: State-Based Marketplace Technology Platform and Consumer Assistance Center
State-Based Marketplace Requests for Proposals (RFP)
Thinking of putting out an RFP? Here are what other states have done.
- MNsure (Minnesota): Consumer and Small Business Shopping, System of Record, and Enrollment Decision Support Tools for MNsure RFP (PDF)
- Silver State Health Insurance Exchange (Nevada): Health Insurance Exchange Technology Platform and Customer Service Center
- beWellnm (New Mexico): Individual Marketplace & Customer Engagement Center RFP
- Pennsylvania Health Insurance Exchange Authority (Pennsylvania): Technology Platform and Consumer Assistance Center for the Pennsylvania Health Insurance Exchange
- Get Covered New Jersey (New Jersey) The Development of a Technology Platform and Consumer Assistance Center for New Jersey’s State Based Health Exchange
Market Studies & Webinars
How do state-based exchanges affect local health insurance markets? Below are some resources to help you consider how an SBM may impact your state.
- Study: States Seek Greater Control, Cost-Savings by Converting to State-based Marketplaces – Robert Wood Johnson Foundation
- Study: Wide Variations in State Health Insurance Costs – 4SightHealth
- Study: Health Insurance Markets Perform Better in States That Run Their Own Marketplaces – The Commonwealth Fund
Interviews & Additional Resources
- NASHP: Nevada’s Insurance Exchange Director Talks about Transitioning to a State-Based Marketplace and Saving Millions
- NASHP: “So You Want to Build a State-based Marketplace? Here’s How!” — Advice from Marketplace Leaders
- CBPP Report: Adopting a State-Based Health Insurance Marketplace Poses Risks and Challenges
Get in touch
Want to learn how an SBM can specifically help your state, as well as estimate your savings? Email GetInsured’s Business Development at email@example.com.