Smart Benefits: CMS Proposes Improvements for Marketplace
Rob Calise, GoLocalProv Business/Health Expert
Smart Benefits: CMS Proposes Improvements for Marketplace
The Notice includes several proposed policy changes that would apply to coverage available to consumers in 2017, including:
• Provider Network Adequacy Standard: To protect access to healthcare providers and delivery organizations in light of a broad shift toward narrow provider networks, CMS is proposing asking states to establish a provider network adequacy standard for plans in the federal marketplace, subject to minimum criteria established by CMS.
• Standardized Options: To make it easier for consumers to compare plans based on key provisions, CMS is proposing to give issuers the choice to offer plans with standardized options such as cost-sharing along with other plans with more variable plan designs so consumers can more easily choose the plan that’s right for them.
• Out-of-Pocket Costs: To reduce surprises, CMS is proposing a requirement that health plans in the federal marketplace count certain out-of-pocket expenses on unexpected out-of-network services towards a policy holder’s annual out-of-pocket maximum if they were performed in-network and advance notice wasn’t provided. For example, if a patient had surgery at an in-network facility and later learns the anesthesiologist wasn’t part of the health plan’s network, cost-sharing charges for the anesthesiologist’s services would count toward the out-of-pocket maximum.
CMS is seeking comment on these and many other proposals in the Notice, details of which can be found here.
20 Cool Small Businesses in RI
Trinity Brewhouse
186 Fountain Street, Providence RI
Trinity Brewhouse brews it's own award-winning beers in house, for a fresh experience every time. They also offer a $50 annual fee to become a member of their Mug Club which offers discounts on drinks and food.
Sproutel
The Sproutel is well-known for creating Jerry the Bear - an interactive toy that teaches children with diabetes how to care for themselves. The Providence-based business is currently expanding their technology to accommodate children with other conditions.
Photo: Sproutel
Pranzi Catering
10 Rosario Dr., Providence, RI
Pranzi has catered for all types of events from weddings to corporate luncheons. Owner and founder Lisa Mattiello was recently named the "2014 Rhode Island Small Business Person of the Year" by the Resource Guide for Small Business.
Photo: Pranzi
The Green Grocer
934 East Main Rd., Portsmouth, RI
The Green Grocer is an organic market out of Portsmouth that supports local farmers. The market has also won many an award under owner John H. Wood II including: the "Veteran-owned Small Business of the Year" award from the Small Business Administration.
Sweet Berry Farm
915 Mitchell’s Lane, Middletown, RI
Sweet Berry Farm has everything you would expect from a local farmer's market and more. They feature juried art exhibitions, a sit-down cafe, and prepared foods for when you are on the run.
Photo: Clare Rok
Verde Vineyards
50 Hopkins Avenue, Johnston, RI
Verde Vineyard is a family owned and operated vineyard based in Johnston. The business is known for giving free tours and tastings on the weekends.
Photo: Verde Vineyards
Swipely
10 Dorrance St., Providence, RI
Swipely is turning payment systems for businesses into upgraded, secure payment solutions with their innovative technology for businesses of all sizes.
Photo: Swipely
Craftland
212 Westminster St., Providence, RI
Craftland was once a holiday store which came around annually to sell its wares. But now it has grown into a full-time shop front for local artisans to sell everything from jewelry to home goods.
Photo: Jen Brister of Brister Photo
Microdermal Pigmentation
989 Reservoir Ave., Cranston, Rhode Island
The Center for Microdermal Pigmentation is the only business of its kind in the area offering permanent makeup solutions.
New Harvest Coffee
65 Weybosset, Providence, RI
New Harvest Coffee Roasters opened a second location in the Arcade earlier this year and offers a wide variety of cocktails and freshly roasted coffee selections.
Medici Gelato
74 Maple Ave., Barrington, RI
Medici Gelato is a tiny shop in Barrington which opened in September and features an ever-changing variety of freshly made authentic gelato (which you can try before you buy), along with tiramisu and cookies!
Muse
279 Water St, Warren, RI
Muse American Handcrafted is tax-free everyday and offers custom wedding band services. All of their jewelry is 100% handcrafted in America by local artisans.
Barrington Books
184 County Rd, Barrington, RI
Barrington Books has been awarded year after year as the "Best Independent Bookstore" on the East Bay and often hosts book signings by local authors.
Gents
1000 Chapel View Blvd., Cranston, RI
Gents specializes in old-fashioned, full service barber shop and spa. They specialize in services including straight-razor hot shaves, shoe shines and massages.
Frog and Toad
795 Hope St., Providence, RI
Frog and Toad of Providence has locally made and handcrafted T-shirts, jewelry, handbags, and home goods as well as free trade items from around the globe.
Professor Chef
41 Lookout Ave, North Providence, RI
Professor Chef is run by a husband and wife team and provides courses on how to cook a full course meal, and wine making among others. The courses are highly interactive so taste, prep and enjoy in your home or in their kitchen.
bin 312
312 South Main St., Providence, RI
bin 312 features a wide selection of wines and spirits and hosts free tastings every Thursday night!
Justine's
11 Olneyville Square, Providence, RI
Justine's is Olneyville's best kept secret, a speak-easy 1920's bar atmosphere with an actual functioning lingerie shop "front".
Frey Florist & Greenhouse
50 Radcliffe Avenue Providence, RI
Frey Florist and Greenhouses has been family owned and operated since 1973, and creates custom arrangements for every occassion that can be delivered around town by request.
Photo: Frey Florist and Greenhouses
Providence Perfume Compan
301 Wickenden St., Providence, RI
Providence Perfume Company allows you to create your own signature scent by blending their 100% natural botanical ingredients.
Photo: Providence Perfume Company
