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In order to be approved to offer one or more Multi-State Plan options, an insurer, among other things, must—
OPM negotiates terms of coverage with each Multi-State Plan issuer, including medical-loss ratio, profit margin, premiums and provider networks. OPM may prohibit issuers from offering MSP options on the Marketplace that fail to meet these terms and conditions.
As required by the Affordable Care Act, MSP insurers in each State must offer at least one plan that does not include elective abortion services. In 2015, most MSP insurers do not offer an MSP option that covers elective abortion. In many of these States, insurers offering non-MSP choices on the Health Insurance Marketplace are offering plans that cover elective abortions.
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