…of Texas, recently announced its decision to cancel grandmothered policies effective December 31, 2014. In an email to brokers, they said it was “based on the ability to administer and provide a comprehensive benefit plan.” The company called on brokers to help transition their clients to ACA-compliant plans. These companies could have chosen to renew these non-compliant plans, because in…
…marketplace “plan management” function. Under the law, plan management includes not just the responsibility to certify qualified health plans, but also to collect and review rate information from participating insurers. (For a comprehensive discussion of marketplace plan management, see CHIR’s 2012 report, Plan Management: Issues for State, Partnership, and Federally Facilitated Health Insurance Exchanges). The ACA requires the Marketplaces to…
Employees of small businesses with fewer than fifty workers have traditionally been at a disadvantage when it comes to accessing health insurance coverage compared to their counterparts with large employers. Prior to the Affordable Care Act, various factors made offering health insurance too costly or too administratively difficult for many small businesses. Unlike large employers, the few small businesses that…
…have the capacity to handle these active renewals, and that they have robust online, telephone, and in-person assistance trained and available to help consumers through the process. Stay tuned: As part of an ongoing project for the Commonwealth Fund to monitor implementation of the health insurance marketplaces, CHIR researchers will soon publish state-by-state data on marketplace plan participation for 2015….
…below. Dental Coverage Q9 (UPDATED Q&A): A consumer is enrolled in both dental and medical coverage through the Marketplace but no longer wants to have dental insurance. Can the consumer only cancel the dental coverage and keep the medical coverage? A9: The Marketplace HealthCare.gov website and Call Center do not currently have the functionality to allow a consumer or one…
By Sonya Schwartz, Georgetown University Center for Children and Families New data zeroes in on a subgroup of uninsured adults not always studied: uninsured parents. An Urban Institute report released September 9th found that more than half (57 percent) of uninsured parents surveyed in March/June 2014 were Hispanic and more than one-third (38.4 percent) said their primary language was Spanish….
By Edwin Park, Center on Budget and Policy Priorities The House this week is scheduled to consider a bill sponsored by Rep. William Cassidy (R-LA) that would allow insurance companies, through 2018, to continue to offer to any small employer the health insurance plans in the small group market that the insurers were selling in 2013. In short, the bill…
By Tricia Brooks, Georgetown University Center for Children and Families CMS has adopted the proposed rules for QHP renewal and redetermination of premium tax credits published with very few changes. As I wrote in this blog, the good news is that the final rules provide an opportunity for consumers to be automatically re-enrolled in the same or a similar plan…
…The subgroup then asked these groups to provide written suggestions for updates to the model, which staff compiled into a master chart. The NAIC consumer representatives submitted comments that focused on (1) a more robust, quantifiable standard for network adequacy, (2) better oversight of plan compliance, (3) an end to balance billing by out-of-network providers working in in-network facilities, and…
…in 2014. The federal government will continue to provide approximately $150 million for consumer assistance through community health centers. With more limited funding available to operate, consumer assistance programs will need to get creative in reaching the remaining uninsured individuals and renewing current enrollees. Consumer assistance programs may need to establish or leverage partnerships with Medicaid agencies, local agents and…
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