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    OpenPayerPolicy UpdatesAdministrative/Operational PolicyAlabama DOI enforcement policy update | OpenPayer
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    CurrentAlabama Department of InsurancePolicy 2016-02

    Enforcement of Federal laws and regulations for health insurance

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    States the Alabama Department of Insurance's collaborative enforcement agreement with CCIIO to review rates and forms for federal compliance and provides 2016-2017 filing deadlines and contact points for issuers operating in Alabama.

    Policy Summary
    PayerAlabama Department of Insurance
    PolicyEnforcement of Federal laws and regulations for health insurance
    Policy CodePolicy Policy 2016-02
    Change TypeInformational — no material coverage changes
    Effective DateMay 10, 2016
    Next Review DateN/A
    Key ActionDepartment will review rates and forms for compliance with federal law under a Collaborative Enforcement Agreement with CCIIO.
    SourceLink
    POLICY UPDATE CHANGES

    No material clinical or coverage changes in this revision.

    July 15, 2016Rate filing deadline
    Apr 11, 2016Form submission window opens
    May 11, 2016Form submission deadline
    Nov 1, 2016Open enrollment start

    OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.

    Filing Deadlines and Submission Windows

    Filing deadlines and submission windows

    Filing deadlines and submission windows for plan year 2017 and related processes for Alabama issuers.

    The Department will follow the form filing windows and deadlines outlined in CCIIO's Final Letter to Issuers and the QHP Issuer guidance for plan year 2017.

    ALL of the following

    • Submission window for form filings for Plan Year 2017 opens: April 11, 2016.
    • Applies to QHP and Non‑QHP individual and small group health insurance markets.

    ALL of the following

    • Submission deadline for most individual and small group form filings (except small group non‑QHP, student health, and large group): May 11, 2016.
    • These filings may be submitted quarterly where applicable.

    ALL of the following

    • Small group non‑QHP, student health, and large group form filings: submission is continuous and the window will not close on May 11, 2016.
    • Student health and large group form filings should be submitted at least 60 days prior to the first market date.

    ALL of the following

    • Rate filing deadline for Alabama (plan year 2017): July 15, 2016.
    • The Department set this rate filing deadline and it differs from the date previously provided by CCIIO.

    ALL of the following

    • Deadline for issuer submission of changes to QHP applications: August 23, 2016.
    • Recommendations from QHP issuers to Plan Management: September 2, 2016.

    ALL of the following

    • Open Enrollment for plan year 2017 begins: November 1, 2016.
    For filing instructions, templates, and additional QHP issuer information, issuers should refer to the CMS/CCIIO marketplace resources as cited in the bulletin and follow Department guidance for non‑QHP filings.
    Contact points: For rate filing questions contact Steve Ostlund (steven.ostlund@insurance.alabama.gov). For form filing questions contact Yada Horace (yada.horace@insurance.alabama.gov) or Anthony Williams (Anthony.williams@insurance.alabama.gov).

    Enforcement Authority and Issuer Responsibilities

    Documentation Required

    State review under Collaborative Enforcement Agreement with CCIIO

    The Department of Insurance will take over the review of rates and forms for compliance with federal law and regulations under a Collaborative Enforcement Agreement with the Center for Consumer Information and Insurance Oversight (CCIIO).

    Collaborative Enforcement Agreement

    Collaborative Enforcement Agreement — definition
    Agreement nameCollaborative Enforcement Agreement between the Alabama Department of Insurance and the Center for Consumer Information and Insurance Oversight (CCIIO)
    PurposeAuthorizes the Department to take over review of rates and forms for compliance with federal law and regulations
    PartiesAlabama Department of Insurance and CCIIO (U.S. Department of Health and Human Services)
    ScopeReview of rates and forms for compliance with federal health insurance laws and regulations
    Effective/Notice date in bulletinMay 10, 2016 (Bulletin No. 2016-02)
    Policy Summary
    PayerAlabama Department of Insurance
    PolicyEnforcement of Federal laws and regulations for health insurance
    Policy CodePolicy Policy 2016-02
    Change TypeInformational — no material coverage changes
    Effective DateMay 10, 2016
    Next Review DateN/A
    Key ActionDepartment will review rates and forms for compliance with federal law under a Collaborative Enforcement Agreement with CCIIO.
    SourceLink
    On This Page
    Filing Deadlines and Submission WindowsEnforcement Authority and Issuer ResponsibilitiesCollaborative Enforcement Agreement