Tag: federally facilitated marketplace

Major Policy Changes Take a Backseat to IT During a Transitional Year for Health Insurance Marketplaces

As the health insurance marketplaces prepare for the second year of operation under the Affordable Care Act, IT issues are driving many states’ decisions on whether to operate a state-based marketplace. In their latest blog post for the Commonwealth Fund, CHIR experts Sarah Dash and Kevin Lucia share findings on state IT transitions and major policy actions going into 2015.

Question on Stand-alone Dental Plans and Upcoming Open Enrollment

With the change in weather, we’re beginning to field questions related to the upcoming 2015 Open Enrollment period as part of our technical assistance work funded by the Robert Wood Johnson Foundation. We recently received a question about the consequences of not paying premiums for stand-alone dental plans (SADP) in federally based Marketplaces. Sandy Ahn provides a summary on this issue.

All Enrollees Should Contact the Marketplace at Renewal

We’re about 110 days away from open enrollment into coverage for 2015. In recent guidance, CMS has revealed its plans for plan renewals and eligibility re-determinations for people enrolled in plans through the marketplaces. Our Georgetown colleague Tricia Brooks takes a look at the envisioned process and some of the benefits – and pitfalls – for consumers.

Grace Periods for Failing to Pay Insurance Premiums: What Consumers Need to Know

On July 16 the Obama Administration published guidance for insurers in the federally facilitated marketplaces (FFMs) regarding a requirement that they provide a 90-day grace period to policyholders who fail to pay premiums. Sabrina Corlette reviews the new rules and offers some advice for consumers who might find themselves in this situation.

ACA Days of Summer

It’s getting to be a summer tradition: a new set of court decisions on the Affordable Care Act. This past week two courts reached opposite conclusions on whether the IRS can issue subsidies through the federally facilitated marketplaces, affecting potentially 7.3 million people. Research Fellow Sandy Ahn talks about these decisions and their impact on the ACA’s ability to address the “three As” of health coverage: access, affordability, and adequacy.

Enrolled in a Plan that Doesn’t Cover Your Prescription Drug: What Consumers Need to Know

One of the key consumer protections in the Affordable Care Act is the requirement that plans must have a limit on out-of-pocket costs. However, there are limits on the limit, and the details matter. Consumers who need a non-formulary drug run smack into one of those limits, but they have options to get the drugs they need as a covered benefit. JoAnn Volk provides a run down.

State Restrictions on Health Reform Assisters May Violate Federal Law

Regulations issued last month by the Department of Health and Human Services show that laws in more than a dozen states may be invalid because they go too far in restricting the work of consumer assistance personnel certified under the Affordable Care Act. In a blog post published by The Commonwealth Fund, Justin Giovannelli, Kevin Lucia, and Sabrina Corlette discuss these new rules and how they affect state efforts to regulate consumer assisters.

New Healthcare.Gov Screener Tool Needs Fixes to Avoid Confusing Consumers

Now that open enrollment into the new health insurance marketplaces is over, the only way people can enroll in marketplace coverage is by qualifying for a special enrollment period because of a life change such as a birth, marriage, a move, or a divorce. Healthcare.gov recently made available a new “screener tool” to help consumers determine whether they qualify. CHIR’s Sabrina Corlette took the new tool for a test drive and has a few suggested improvements.

Florida Complaint Should be Welcomed by Regulators and Advocates

A recent complaint filed with the U.S. Department of Health and Human Services’ Office of Civil Rights against four Florida insurers targets them for violating the Affordable Care Act’s prohibition against discrimination. CHIR expert Sally McCarty evaluates the complaint and its implications for consumers and state insurance regulators.

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.