43.71.065  <<  43.71.070 >>   43.71.075

Rating systemRating factors.

The board shall establish a rating system consistent with applicable federal law, for qualified health plans to assist consumers in evaluating plan choices in the exchange. Rating factors established by the board may include, but are not limited to:
(1) Affordability with respect to premiums, deductibles, and point-of-service cost-sharing;
(2) Enrollee satisfaction;
(3) Provider reimbursement methods that incentivize health homes or chronic care management or care coordination for enrollees with complex, high-cost, or multiple chronic conditions;
(4) Promotion of appropriate primary care and preventive services utilization;
(5) High standards for provider network adequacy, including consumer choice of providers and service locations and robust provider participation intended to improve access to underserved populations through participation of essential community providers, family planning providers and pediatric providers;
(6) High standards for covered services, including languages spoken or transportation assistance; and
(7) Coverage of benefits for spiritual care services that are deductible under section 213(d) of the internal revenue code.
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