For most Americans, 2020 was a terrible, horrible, no good, very bad year. But not for health insurance companies. As the year comes to a close, it is increasingly apparent that they are enjoying high levels of profitability. In their third quarter earnings reports, Humana, Cigna, and Centene reported $1.3 billion, $1.4, billion, and $538 million in profits, respectively. UnitedHealth…
…for all applicable years. This will allow you to maintain eligibility for APTCs even if the IRS’ data has not been updated. Open Enrollment runs through December 15th in most states. Look out for more weekly FAQs from our new and improved Navigator Guide, or browse our COVID-Resource Center for additional resources to stay up to date on the latest…
…states can partially finance reinsurance with federal dollars available under the ACA’s Section 1332 Waivers. In a new issue brief for the Commonwealth Fund, CHIR experts explore the benefits and limitations of state-run individual market reinsurance programs by analyzing premium, enrollment and insurer participation data, as well as key program design decisions for states. The study finds that, while reinsurance…
By Sabrina Corlette and Madeline O’Brien With the news that promising vaccines are close to approval comes hope that the COVID-19 pandemic will soon end. The federal government is working with states on the herculean task of distributing the vaccine safely and efficiently. Equally important is making sure that people can receive the vaccine for free, regardless of their insurance…
…have access to or are enrolled in a plan that qualifies as minimum essential coverage affects your ability to receive premium tax credits and whether or not you may qualify for most special enrollment periods. The following types of coverage will allow you to comply with the individual mandate and qualify for most special enrollment periods if you lose it:…
…comprehensive cap on both in-network and out-of-network prices could encourage more broad price reductions, but policymakers may have more difficulty ensuring compliance among providers who attempt to circumvent this measure. Fiedler finds that providers may respond to a loss of negotiation power by seeking other allowances from insurers, such as by demanding higher prices for other services, using alternative payment…
…plans can be aggressive, confusing, deceptive or in some cases part of an outright fraud. Consumers should know that the only surefire way to guarantee that they are buying comprehensive, ACA-compliant health coverage is through Healthcare.gov. If shopping outside the marketplace, be sure to ask clear and direct questions to make sure that you are buying ACA-compliant individual market insurance…
…allow small employers to keep these noncompliant policies if they begin on or before October 1, 2020 and come into compliance with the ACA by January 1, 2021. Other forms of coverage also do not have to comply with the Affordable Care Act’s requirements, including short-term limited duration insurance, association health plans, and Health Care Sharing Ministries. See the Navigator…
…has sprung up, due in no small part to federal actions expanding alternative products and encouraging their sale. Non-ACA-compliant products have been touted as a cheaper coverage option, but the lower sticker price is a result of these companies employing tactics that the ACA expressly forbids, including discriminating against sick people and failing to cover key health services. It is…
…covered benefits under all marketplace plans be the same? How can I compare? In general, marketplace health plans are required to cover the 10 categories of essential health benefits. However, insurers in many states will have flexibility to modify coverage for some of the specific services within each category. Any modifications must be approved by the marketplace before plans can…
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