Bill payment. Accepting payment is not required of a state-based marketplace, and the Board approved deferring this option until after the core items are addressed. The ACA requires insurance carriers to be ready to accept the first payment from consumers, and our carriers are prepared to bill and receive the first payment from our enrollees.Although bill payment is optional for individuals per the Affordable Care Act, we reported back in September that, according to Betsy Charlow (communications manager for the Maryland Health Connection,) "employer bills get handled by Maryland Health Connection (federal requirement)," and not just the initial paymen, either. Ms. Charlow went on to say that "the employer would not get multiple bills. The SHOP would aggregate all carrier bills so the employer can make one payment. The Maryland Health Benefit Exchange would then distribute payment to the appropriate carriers on behalf of the employer."
If the exchange has delayed even the relatively simple feature of accepting initial payments from individuals to be remitted to insurance carriers, the more complex aggregation of premium billings from multiple carriers and the collection and distribution of those dollars on an ongoing basis will certainly require far more resources and planning. As I reported at The Weekly Standard, the launch of SHOP in Maryland has been postponed until April 1, 2014. The Maryland board is counting on the additional three months to make sure that the opening of the SHOP Marketplace does not mirror the debacle that accompanied the debut of the individual insurance exchange.