By Tricia Brooks, Georgetown University Center for Children and Families Let’s face it. Health insurance is complex, even for those of us who have worked in the field for years. Combine that with applying for means-tested financial assistance (through systems that are still being debugged), and there is no doubt that it can be a frustrating experience for consumers. Numerous…
By Tricia Brooks, Georgetown University Center for Children and Families Many of us have been asking this question for months: How many people who purchased coverage through the Marketplaces missed out on lower cost sharing because they did not enroll in a Silver plan? Now we have an estimate thanks to a new analysis by Avalere Health. Avalere’s headline –…
…ACA requires insurers, both inside and outside the health insurance marketplaces, and employer-sponsored health plans to report the following data to state and federal officials and the public: Claims payment policies and practices; Periodic financial disclosures; Data on enrollment; Data on disenrollment; Data on the number of claims that are denied; Data on rating practices; Information on cost-sharing and payments…
…on their plates but also because of opposition from insurers and employers. The transparency provisions require insurers and group health plans to report to the federal government, state departments of insurance, the health insurance marketplaces and the public a range of data, including information about their practices for setting premium rates and paying or denying claims, the enrollment and disenrollment…
…dollar by actively renewing. We also found that consumers were surprised by higher-than-expected premium bills in January when they were automatically renewed. Some consumers will likely have similar experiences in 2016, but marketplace executives have learned important lessons about communicating with consumers about their renewal options, and hopes are high that the second renewal season will go much more smoothly….
…and $13,700 in 2016. And the limits come with some potential holes: plans don’t have to count out-of-network care or services that fall outside of the Essential Health Benefits package toward the annual limit. While it may not have been entirely clear what “other than self-only” coverage meant, the Administration clarified in the preamble to federal rules and again in…
…use more support from the marketplaces. Eight-six percent of Assister Programs indicated they would like additional training on a range of complex issues. Programs also report that marketplace websites and call centers need improvement. Those that coordinated with other programs did better. Returning Programs that coordinated often with other Assister Programs were more likely to increase the number of people…
As readers of CHIRblog know, Georgetown experts have had funding from the Robert Wood Johnson Foundation to provide technical assistance to navigators and assisters in 5 states through two rounds of Open Enrollment. We’ve compiled almost 300 FAQs in a Navigator Resource Guide and have shared with CHIRblog readers some of the questions we’ve received. The work has brought it’s…
…Kentucky, Maryland, Rhode Island and Washington, re-enrolled marketplace customers in large numbers in spite of some challenges, and that an active renewal process, if effectively managed and communicated to consumers, can support significant retention of enrollees. Some major challenges One major challenge for the SBMs was to redetermine consumers’ eligibility for premium tax credits. Some SBMS also struggled with messaging…
…subject to scrutiny by the states to ensure that they are reasonable prior to being approved and passed on to consumers. To ensure that rate increases are fair, the Affordable Care Act (ACA) requires state insurance departments to have “effective-rate-review” programs whereby they conduct a comprehensive review of proposed rate increases to ensure that such are reasonable and allow the…
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.
