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Final Regulations Issued for Individual Market Stabilization

April 13, 2017 Department of Health and Human Services (HHS) issued final regulations to help "stabilize" the individual & family health insurance market.  These will take effect June 19th, 2017.  

Shortened Open Enrollment Period
2018 Open Enrollment Period will be shortened from 3 months to 6 weeks.  OEP will run from November 1st through December 15th 2017.  That's it!

Greater Control Over Special Enrollment Periods
The rules expand verification of eligibility for special enrollment periods in Marketplaces, limit the ability of Marketplace enrollees to change plan metal levels during the coverage year, and adjust requirements for special enrollments due to marriage.

Promote Continuous Coverage
Issuers will be allowed to collect premiums for unpaid coverage within the past year before re-enrolling individuals for the next year to promote continuous coverage.

Increase Consumer Choice
To help provide enrollees with more coverage options, beginning with 2018 plans, issuers will have greater actuarial value flexibility to offer more lower-cost choices and to continue offering existing plan options.

Empower States for Network Adequacy and Plan Design
CMS will defer oversight of network adequacy and health plan certification to states that have sufficient review processes to determine adequacy for their residents.


California Insurance Commissioner Dave Jones has requested (in a March 29th letter to President Trump) that states be given the flexibility to set their own open enrollment periods so long as they encompass the dates of the federal enrollment period (6 weeks),  I agree with the commissioner that 45 days would be an extremely constricted enrollment period for California (and other states).  


Dave

www.davefluker.com





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