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The following questions have been received by the Idaho Department of Insurance regarding the Idaho Health Insurance Exchange and SHOP (Idaho Exchange), the filing process, Qualified Health Plan standards, and other related topics. The answers are intended to offer guidance on current issues based on the DOI’s current understanding of applicable federal and state law requirements. If you have any concerns regarding the accuracy of any of the guidance, please contact Wes Trexler at the DOI by phone at 208-334-4315 or email. The DOI will continue to release additional information and revise these responses as needed.

Check out our other ACA FAQ pages: 2013, 2014, 2015, 2016/2017, 2018
Can a spouse (or other family member) be counted as an employee in a small employer health plan?

With the final market stabilization rule being released so late, will there be any changes to the 2018 QHP filing timeline?

There is uncertainty at the federal level about the funding of the cost sharing reductions (CSRs). Should insurers file rates assuming the CSRs are funded for 2018 or not funded?

The IRS has communicated that tax filings without an indication of health insurance coverage won’t be “systemically rejected by the IRS at the time of filing.” Should insurers file rates assuming IRS will continue that practice in 2018?

There was 2017 Idaho legislation to modify the Idaho Individual High Risk Pool, but there are not yet parameters around how the change may impact ACA-compliant plans. How should insurers include the impact of the change in their 2018 rate filings?

There have been national insurers reducing or eliminating agent commissions in certain cases which can have the effect of discouraging the offering of certain insurance coverage to certain individuals. What is Idaho DOI’s position on this?

What is the Department’s position on small employer group “carve-outs,” in which eligible employees are classified into different groups (for example, hourly versus salaried) and are offered different benefits?

What is the definition of "Idaho resident" for the purpose of determining eligibility to enroll in a health insurance plan?

If your question is not answered above, please submit your question directly to the DOI.

Check out our other ACA FAQ pages: 2013, 2014, 2015, 2016/2017, 2018

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