By Jack Hoadley, Georgetown University Health Policy Institute On March 25, the Administration created a grace period that will extend the March 31 Marketplace enrollment deadline for Americans who have run into roadblocks in their attempts to sign up for insurance coverage under the Affordable Care Act (ACA). Various reporters and commenters have pointed to parallels with decisions made in…
Over the last several months, faculty and staff at CHIR and their sister Center, Georgetown’s Center for Children and Families (CCF), have been providing support and technical assistance to navigators and others assisting consumers with enrollment in the new health insurance Marketplaces.* While the enrollment process can be tricky at multiple steps, navigators report that it can be particularly difficult…
By Tricia Brooks, Georgetown University Center for Children and Families With the deadline for the initial open enrollment on March 31 looming, consumers, advocates, and assisters have been stressing over what happens to people who, for no fault of their own, have not been able to complete their enrollment on HealthCare.Gov or through the federal call center. Late yesterday, federal…
For years, small businesses have been at a disadvantage compared to larger firms when it comes to offering insurance to their employees. To remedy the situation, the Affordable Care Act institutes small-group insurance market reforms and puts into play an idea that has been around for a long time but has never before been tried nationwide: allowing small businesses to…
…organized by subject matter. An easy-access index directs CSRs to entries, which appear in plain, non-legalese language to allow CSRs to review items quickly when working with consumers. An 11th section, “Process for Responding to Consumer Inquiries,” provides a place for states to describe their processes and procedures for handling various types of complaints and inquiries. The appendices include a…
…These policies are considered “excepted benefits” under the Public Health Service Act, and exempted from the consumer protections in the ACA that apply to traditional insurance, such as a minimum set of comprehensive benefits and a cap on out-of-pocket costs. However, both federal and state regulators have expressed concerns that insurance companies could attempt to market these policies in such…
…from insurance companies would be preempted. State rules that otherwise prevent assisters from continuing to perform their Federally required duties. For example, a state rule requiring fingerprinting or a background check would be permissible, but if it includes a deadline for compliance that makes it impossible for a Federally approved assister to comply in a timely way, it would be…
…can devote to profits and administrative costs (20 percent in the individual and small employer markets and 15 percent in the large employer market) compared to what they spend on patient care. In the employer group market, if an insurance company does not meet this standard, they are required to return the difference to the policyholder (usually the employer) or…
By Joe Touschner, Georgetown University’s Center for Children and Families As families have signed up for new marketplace coverage over the past several months, many questions have come up around dental benefits. I wanted to pass along some useful resources for understanding 2014 plans as well as the latest news on how marketplace dental plans will change for 2015. First,…
…rules and guidance from federal regulators. Those increased costs were compounded when the forms insurers received from the federal government with critical data on new enrollees – called “834”s arrived riddled with errors, or did not arrive at all – requiring manual data entry and one-on-one follow up. In addition, when the Administration announced in November that it would allow…
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