Premium Collection in State Based Exchanges

Prepared for the Robert Wood Johnson Foundation's State Health Reform Assistance Network

Health Insurance Exchanges organized pursuant to the Affordable Care Act (ACA) have certain requirements and several options with respect to providing premium collection services for small businesses and individual consumers purchasing qualified health plans (QHPs) in 2014. While collection functionality is required in Small Business Health Options Program (SHOP) Exchanges, it is an optional service in the individual Exchanges.

This issue brief summarizes federal policy guidance and outlines requirements, options and key considerations for State-based Exchanges to evaluate with respect to Exchange premium collection functionality.

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