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New Regulations Address Program Integrity and Many Other Exchange and Market-Reform Issues
Timothy Jost, in Health Affairs Forefront Link to more items from this source
[Guidance Overview]
June 17, 2013

"Employers with one employee qualify as small groups under the ACA, in contrast to the prior rule of [HIPAA], under which at least two employees were required. The principle business address of the policyholder is used for determining the geographic rating area for determining rates for small groups; the address of the policyholder for determining rates for the individual market, regardless of where various employees or family members live.... [T]he proposed rule reinterprets the ACA (which could be read either way) to permit the establishment of state SHOP-only exchanges (although only if the state has a federally facilitated individual exchange).... A number of the provisions of the proposed rule deal with agents and brokers."

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