State insurance exchanges - North Carolina

Summary of differences between federal and state regulations

The U.S. Department of Health and Human Services (HHS) must make a determination on or before January 1, 2013, that a state will in fact have an exchange in operation by 2014 and that the exchange meets the requirements of the Affordable Care Act (ACA) and HHS guidance. In a letter dated November 15, 2012, Secretary Sebelius indicated that a state may submit both a letter of intent and an application to operate its own exchange by December 14, 2012. If a state elects not to operate an exchange, or if the HHS determines that the state will not be able to have an exchange operational by 2014 that meets the law’s requirements, the ACA gives the HHS the authority to establish and operate such exchange within the state.

In June 2011, North Carolina Gov. Beverly Perdue signed HB 22 which contained the General Assembly’s intent to establish and operate a state-based health benefits exchange.

In September 2010, the North Carolina Department of Insurance received a $1,000,000 State Planning grant for creating an interagency planning group and determine how other programs and processes already in place would be function with the and health benefit exchange.

In June 2011, the North Carolina Department of Insurance received a $12.4 million Level One Establishment grant for analyzing policy decisions, expanding the existing eligibility system of the North Carolina Department of Health & Human services to accommodate an exchange, and develop a work plan, budget, and evaluation plan for the North Carolina Health Benefit Exchange.

State

Contacts

North Carolina Department of Insurance

North Carolina Department of Health and Human Services

Regulations

HB 22

Federal

Contacts Center for Consumer Information and Insurance Oversight (CCIIO)

U.S. Department of Health and Human Services (HHS)

Regulations

45 CFR Parts 155, 156, and 157