Open Enrollment – Will States See the Silver Lining?

With all of the debate and squabbling about health care costs, there has been a general recognition that individuals who don’t qualify for a subsidy under the ACA have been hard hit by premium increases over the past years. In fact, CMS data released earlier this year indicated that non-subsidized enrollees saw a 20 percentContinue reading “Open Enrollment – Will States See the Silver Lining?”

CMS Releases Reminders on Broker Use of Personally Identifiable Information (PII)

CMS released another slide deck to help brokers understand and comply with Marketplace Requirements. The newest deck is titled “Part II: Marketplace Privacy & Security Requirements for Agents and Brokers.” The slide deck addresses the use and protection of Personally Identifiable Information (PII). This latest information updates materials and guidance published last September. PII isContinue reading “CMS Releases Reminders on Broker Use of Personally Identifiable Information (PII)”

CMS Offers Compliance Tips to Brokers in Marketplace

In a newly released slide deck, CMS, the Centers for Medicare and Medicaid Services, offers tips to brokers who assist clients with Marketplace coverage. The slide deck is titled “Compliance with Marketplace Requirements: Considerations for Agents and Brokers.” The guidance reflects concerns CMS has expressed regarding consumer complaints, including some about brokers. CMS is consideringContinue reading “CMS Offers Compliance Tips to Brokers in Marketplace”

Marketplace Broker Training Different for New and Returning Brokers

Brokers who pursue federal marketplace training this year will pursue a different path if they are new to the marketplace or renewing their registration. A returning broker who can use the streamlined refresher training is one who was registered for the marketplace in 2017. To ensure eligibility for refresher training a broker should confirm thatContinue reading “Marketplace Broker Training Different for New and Returning Brokers”

New Rule Aimed at Market Stabilization

The Trump administration has published a new proposed rule aimed at stabilizing the individual insurance market. This coincides with NAHU’s emphasis on the critical need to stabilize the individual insurance market. Critics will say that the rule doesn’t do enough. However, the rule advises that this first step is one of several that will beContinue reading “New Rule Aimed at Market Stabilization”

Marketplace Appeals — The Results

At the risk of sounding like Nick Cannon on the television show  America’s Got Talent when they’re announcing performers advancing to the next round of competition, employers are beginning to see the results of appeals that they’ve filed when employees receive subsidies in the marketplace. Employers are finding some of these appeal decisions perplexing, especiallyContinue reading “Marketplace Appeals — The Results”

“To Fee or Not to Fee” — Considerations and Concerns

Brokers have been buffeted by the myriad changes occurring at record pace over these past few years. The Affordable Care Act (ACA) has had a dramatic impact on the types of health insurance products available, the scope of benefits offered and how brokers are compensated for the valuable services they provide. Many brokers have transformedContinue reading ““To Fee or Not to Fee” — Considerations and Concerns”

CMS Acts on Documentation for Special Enrollment Periods (SEPs)

In an effort to stabilize the individual insurance marketplaces and improve the risk pool CMS has rolled out a new Special Enrollment Verification process. Individuals who assert that they have qualified for one of five Special Enrollment Periods (SEPs) will be sent a Marketplace Eligibility Determination Notice requesting documentation to support their eligibility for theContinue reading “CMS Acts on Documentation for Special Enrollment Periods (SEPs)”

Spring to Sprout Flowers and Appeals!

Flowers may be welcome signs of spring, but a sign that spring is here that may be less welcome is the implementation of the marketplace appeals process for employers. Beginning in 2016, the federally facilitated marketplace (FFM) will send notices to employers if an employee receives APTC and the employee has identified their employer inContinue reading “Spring to Sprout Flowers and Appeals!”

Short Term Policies No ACA Panacea

An insurance product that many thought would become extinct with implementation of the ACA can’t be counted out – yet. Short term health insurance policies have been an attractive short-term option for many years. While the policies generally offer limited benefits, the ability to purchase a plan for 30 days or 6 months or evenContinue reading “Short Term Policies No ACA Panacea”