…refuse the terms and conditions and thus not receive funds. Participation is hard to predict and could vary according to their payer mix, loss of elective patients, or number of COVID-19 patients. It is also unclear how patients will be able to know if a provider treating them has agreed not to send balance bills. Indications from HHS are that…
…of insured Americans under 65 have job-based health coverage, researchers at the Commonwealth Fund and SSRS conducted a survey to study how recent job loss has impacted access to health insurance. What It Finds Forty-one percent of respondents dealing with job insecurity, including job loss, pay cuts, and lost hours, reported either losing insurance, being worried about losing insurance, or…
As COVID-19 cases climb, social distancing – the best tool we have to bring the virus to heel – has wrought an unprecedented loss of jobs, income, and health coverage. Over the coming months, the uninsured rate is expected to skyrocket. In the midst of the public health and financial crises spurred by the novel coronavirus, the Affordable Care Act…
…application. Please keep in mind that as state and federal policy changes during this unprecedented moment, the answers to your questions may change. It is always best to check with your state Marketplace to confirm your options. If you’ve experienced a sudden drop in income due to loss of work hours or loss of employment and want to know if…
…stop insurers from charging higher premiums to sick people. We know that people with underlying conditions are at a higher risk of contracting a severe illness from the novel coronavirus than healthy ones. We’re grateful those discriminatory practices that, 10 years ago, would have barred them from coverage are no longer permitted. Providing Comprehensive Coverage Before the ACA, even people…
…to be a successful stopgap, And for the December Research Round Up, that’s a wrap! Goldin J, McCubbin J, Lurie I. Health Insurance and Mortality: Experimental Evidence from Taxpayer Outreach. National Bureau of Economic Research (NBER), December 6, 2019. Researchers have long considered the question of how access to health insurance impacts mortality rates. Since the famous 2012 Oregon Health…
…and one of the later cases involving Ray Palombo’s Contractors & Merchants Associations, Case No. 50-027125. There are also a multitude of examples of where federal intervention resulted in the plans fixing problems before they appear to have resulted in significant, if any, harm. These changes frequently involved steps like securing stop-loss insurance or fidelity bonds, moving plan assets into…
…opportunity. Some events that trigger a special enrollment opportunity are: Loss of minimum essential coverage or other qualifying coverage. For example, if you lose your employer-sponsored coverage because you quit your job, were laid off, or if your hours were reduced. This also includes “aging off” a parent’s plan when you turn 26 or if you lose student health coverage…
…Association Employee Benefit Plan) As these and other cases show, absent proper actuarial guidance, a plan can become insolvent and face millions of dollars in unpaid claims very quickly. Self-insured MEWAs are required to disclose whether they have stop-loss insurance on their Form M-1, and, when noticed, the absence of stop-loss insurance can trigger an investigation by DOL. See, e.g.,…
…Policy examined how insurer marketplace exits affected consumers’ re-enrollment decisions between 2015 and 2018. What it Finds Over the study period, consumers were 7.1 to 12.9 percent more likely to forego marketplace coverage after their insurer stopped offering marketplace plans. Insurer exits affected unsubsidized consumers significantly more than subsidized consumers, with unsubsidized consumers facing disenrollment increases of 18.3 percentage points,…
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