…and another on what to do when your provider is no longer in-network. The upcoming open enrollment period promises to generate many more questions – such as how to renew or change plans, obtain re-determinations of eligibility for premium tax credits and file for exemptions from the individual mandate. As more questions come in and new federal guidance comes out,…
…are still working through last year’s backlogs. Additionally, the back end functions for transferring data between the marketplaces and insurance companies should also make for smoother enrollment in a qualified health plan. QHP Renewals and PTC Redeterminations – This is where the new production comes in. Most consumers are not required to take action to keep their premium tax credits…
On October 16, the Centers for Medicare & Medicaid Services (CMS) released the language of their privacy and security agreement with insurers participating on the federally facilitated marketplace (FFM). Some sharp-eyed readers saw that the contract included a clause that allows insurers to terminate the agreement, should federal financial assistance cease to be available to the plans’ marketplace enrollees. Many…
As health insurance consumers, one of the most difficult things to understand is what’s covered under our health insurance policies. Unsurprisingly, polls show that many of us don’t understand common terms related to our health insurance coverage, such as “deductible” and “co-insurance.” Our lack of understanding unfortunately limits our ability to buy a health plan that is best able to…
This week, Georgetown University experts from the Center on Health Insurance Reforms and the Center for Children and Families released a report from their ongoing project to support Navigators and consumer assisters. The project, supported by the Robert Wood Johnson Foundation, provides Navigators and other in-person assisters in six states – Arkansas, Arizona, Florida, Georgia, Michigan, and Ohio – with…
…run marketplace to have enacted legislation granting it the necessary legal authority to establish a state-based marketplace. Only one state with a previously federally run marketplace—Mississippi—has opened its own small-business SHOP (Small Business Health Options Program) marketplace since last year. In their latest blog post for the Commonwealth Fund, Sarah Dash and Kevin Lucia share findings on how IT issues…
…of coverage in the United States. Beginning next year, the ACA’s employer mandate will take effect, and employers at least 100 full-time equivalent workers will have to provide coverage to their workers or face a penalty. After 2016, the same requirement will apply to companies with at least 50 workers. In addition to these requirements, federal policy has long provided…
…months’ (or more) notice before closing their practices to new patients, and to commit to keeping their practices open for a year following each open enrollment period. Provisions like these would provide consumers adequate time to find a new provider before a practice is closed for any reason, except the illness or death of a provider. Most of these transparency…
…communications with these 115,000 people. Here, we answer a few basic questions about the complaints and FOIA request and provide links to additional information. Who filed the complaints and what do they allege? Both complaints, filed on behalf of Southeast Asian Mutual Assistance Associations Coalition and the Illinois Coalition for Immigrant and Refugee Rights, assert that the federally facilitated marketplace…
By Tricia Brooks, Georgetown University Center for Children and Families A new report released by the Robert Wood Johnson Foundation and the Kaiser Family Foundation chronicles the challenges, innovations and lessons learned about the needs of consumers for assistance in accessing and using health coverage options under the Affordable Care Act (ACA). The report is compilation of feedback from 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.
