How is the regional alliance supposed to “manage” the geographically defined “market”?
A. Each regional alliance negotiates and contracts with the health insurance plans it approves. The alliance decides which plans are permitted to operate in its geographic area and it exercises firm control over the marketing policies of health plans: “Each regional alliance shall review and approve or disapprove the distribution of any materials used to market health plans through the alliance.”46 Q. Can a regional alliance prevent a plan being offered to consumers? A. Yes. The regional health alliance must normally offer contracts to health plans meeting the federal conditions, but it still has reserve powers to exclude a plan. For example, a regional alliance may exclude a plan if its proposed premium exceeds the average premium within the alliance by more than 20 percent; if the plan fails to offer coverage for “all services” as outlined in the federal government’s comprehensive benefits package; if the alliance finds that the plan discriminates against any group of the basis of ra
