Specifications include, but are not limited to: 1. Standard Plan Design Development and Actuarial Value Certification • Calculate the Federal Actuarial Value (AV) of AHCT’s current standard plan designs for both Medical and Standalone Dental plans to evaluate necessary changes to comply with AV for upcoming plan year. Compliance with the Federal Actuarial Value Calculator is required for all Qualified Health Plans (QHPs) offered by Access Health CT under the ACA. Additional requirements under Mental Health Parity (MHP) must also be met by QHPs and are included in analysis for standard plan design development. • Anticipate, identify and model unique scenarios to show potential viability of alternative plan designs while maintaining compliance with Federal AV and MHP requirements. • Work with Issuers on testing for alternative plan designs and compliance with Federal AV and MHP requirements. • Use market trend and utilization analysis to suggest different approaches to plan design to help diversify consumer choice. • Estimate impact to premium of any changes to standard medical or standalone dental plan designs from the current year to upcoming year. • Prepare and present materials to the Exchange’s advisory committees and Board of Directors. • Present and participate in advisory committee and board of director meetings as requested, and any other meetings with internal staff or carrier representation as necessary. • Provide medical and dental actuarial value certification reports, as needed. 2. Rate Review and Consumer Impact Study • Review both on- and off-Exchange rate filings, where applicable, for carriers participating on the individual and small group medical insurance markets in Connecticut for the applicable plan year. This includes a review of comments from the Connecticut Department of Insurance regarding current rate filings and any modifications to rate filings, and final rate filings to summarize final rate changes. This process may include dialogue with issuers as appropriate to clarify questions in advance of rate filing finalization. • Review and analyze trend and consumer premium impact before and after subsidies. Vendor will calculate and summarize rate increases or decreases from plan year to plan year by rating area and plan type on both individual and small group markets. • Summarize the impact of rate changes on consumers in the individual market who are eligible for subsidies
