Stay ahead of developments in federal and state health care law, regulation and transactions with timely, expert news and analysis.
By Sara Hansard
Sept. 2 — Consumers in the Affordable Care Act health insurance marketplace operated by the federal government will be able to automatically re-enroll in coverage for 2015 under a final rule issued Sept. 2 by the Centers for Medicare & Medicaid Services.
The rule (CMS-9941-F) finalizes a proposed rule issued June 26. It is scheduled to be published in the Federal Register Sept. 5 and is effective 30 days from that date.
Consumers in the federally facilitated marketplace will receive notices shortly before open enrollment begins for 2015, according to a fact sheet issued by the CMS. The notices will explain the “auto-enrollment” process and how consumers can see if they qualify for additional financial assistance and shop for plans, it said. Consumers will also receive notices from their insurance company about 2015 premiums and how much they may save with premium tax credits, it said. Open enrollment begins Nov. 15.
If consumers do nothing, they will be automatically enrolled in the same plan with the same premium tax credits and other financial assistance, if applicable, as in the 2014 plan year, the fact sheet said.
“Consumers are encouraged to return to the Marketplace to make sure they are getting all the financial assistance they qualify for, and to shop for the plan that best suits their needs,” the fact sheet said.
Consumers whose 2013 tax return indicates they had “very high income” or who didn't give the marketplace permission to check updated tax information for annual eligibility redetermination purposes will be enrolled automatically without financial assistance, if they don't return to the federal HealthCare.gov website, the fact sheet said. “This process will help provide continuity of coverage and safeguard taxpayer dollars,” it said.
State-based marketplaces will have the flexibility to propose “unique approaches” to the process, the fact sheet said.
“We are committed to providing a simple, familiar process for consumers to renew their coverage next year,” CMS Administrator Marilyn Tavenner said in the fact sheet. “Consumers should use this time to evaluate their health needs, browse other options, and see if they qualify for additional financial assistance. However, consumers who are happy with their plan and have no changes to their income or family situation can be auto-enrolled in their same plan next year, similar to how it is done in the employer insurance market today.”
Researchers have warned that many consumers who are automatically re-enrolled in plans for 2015 may receive lower subsidies than they would if they went through a redetermination process. In comments on the proposed rule, health insurers and hospitals supported the idea of automatic re-enrollment, saying consumers should have a streamlined process to update their income and eligibility information for advance premium tax credits without having to go through the entire application process.
A notice sent to Capitol Hill health staff said guidance on final issuer notices was to be posted later Sept. 2.
To contact the reporter on this story: Sara Hansard in Washington at firstname.lastname@example.org
To contact the editor responsible for this story: Janey Cohen at email@example.com
All Bloomberg BNA treatises are available on standing order, which ensures you will always receive the most current edition of the book or supplement of the title you have ordered from Bloomberg BNA’s book division. As soon as a new supplement or edition is published (usually annually) for a title you’ve previously purchased and requested to be placed on standing order, we’ll ship it to you to review for 30 days without any obligation. During this period, you can either (a) honor the invoice and receive a 5% discount (in addition to any other discounts you may qualify for) off the then-current price of the update, plus shipping and handling or (b) return the book(s), in which case, your invoice will be cancelled upon receipt of the book(s). Call us for a prepaid UPS label for your return. It’s as simple and easy as that. Most importantly, standing orders mean you will never have to worry about the timeliness of the information you’re relying on. And, you may discontinue standing orders at any time by contacting us at 1.800.960.1220 or by sending an email to firstname.lastname@example.org.
Put me on standing order at a 5% discount off list price of all future updates, in addition to any other discounts I may quality for. (Returnable within 30 days.)
Notify me when updates are available (No standing order will be created).
This Bloomberg BNA report is available on standing order, which ensures you will all receive the latest edition. This report is updated annually and we will send you the latest edition once it has been published. By signing up for standing order you will never have to worry about the timeliness of the information you need. And, you may discontinue standing orders at any time by contacting us at 1.800.372.1033, option 5, or by sending us an email to email@example.com.
Put me on standing order
Notify me when new releases are available (no standing order will be created)