Open Enrollment in most states ends Sunday, December 15. After the enrollment period ends, in order to be able to sign up for ACA-compliant health insurance, you will need to qualify for a Special Enrollment Period (SEP). We’ve gathered a few frequently asked questions (FAQs) about Special Enrollment Periods from our Navigator Resource Guide to help you know your options….
…Case No. Description 70-016407 California Trucking Association improperly collected nearly $300,000 in marketing and administrative fees and commission payments from the fully insured AHP it sponsored between 2010 and 2013, because it was a plan fiduciary and this constituted self-dealing. 43-009439 ICUL Service Corporation (ServiceCorp), a for-profit, wholly owned subsidiary of the Indiana Credit Union League, collected $1,841,249 in commissions…
…specialties as off-marketplace commercial plans. Compared to a theoretical unrestricted fee-for-service (FFS) plan offering access to all providers in the study specialties, off-marketplace commercial plan networks only contain about one-third of providers in those specialties. “Artificial local provider deserts,” or areas where there are providers in a certain specialty that are excluded from provider networks are more common in micropolitan…
…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…
…the ACA is far from certain, but right now, there’s a cornucopia of protections to give thanks for. We’ve picked a few to savor, so let’s set the table: Dress Your Turkey with Coverage for Pre-Existing Conditions The centerpiece is made with the ACA’s principal elements, all critical protections against discrimination. Prior to the ACA, it was common for insurers…
…Compare on Coverage and Costs. Urban Institute; October 16, 2019. With health care a top policy issue being debated by the 2020 presidential candidates, researchers at the Urban Institute analyzed eight different combinations of proposed reforms to national health insurance coverage and spending, comparing outcomes of the policy packages with current law. These reform combinations include: Building on the ACA:…
…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 Resource Guide’s Other…
…either at an out-of-network facility or from an out-of-network physician, or 2) when the patient receives elective nonemergency care at an in-network facility but receive services during their stay from an out-of-network health care provider, such as an anesthesiologist, radiologist, hospitalist, or other physician. Since the insurer does not have a contract with the out-of-network facility or physician, it may…
…internal memos and notes; voluntary compliance letters, case closure letters, and other communications between DOL and parties under investigation; and association charters, bylaws, and articles, plan documents, and other factual material. To date, we have received and posted files from New York, Seattle, Chicago, Boston, Cincinnati, and Los Angeles. What’s more, to make these records readily accessible to the public,…
…lower deductibles, co-pays, coinsurance and out-of-pocket limits compared to regular silver plans. Once the marketplace determines you are eligible for cost-sharing reductions, you will be able to select one of these modified silver plans, based on your income level. Open Enrollment runs through December 15th in most states. Look out for more weekly FAQs from our new and improved Navigator…
The opinions expressed here are solely those of the individual blog post authors and do not represent the views of Georgetown University, the Center on Health Insurance Reforms, any organization that the author is affiliated with, or the opinions of any other author who publishes on this blog.
