On July 16, 2014, the Consumer Information and Insurance Oversight (CCIIO) division of the Centers for Medicare & Medicaid Services (CMS) released an Enrollment Bulletin for the individual markets of Federally-facilitated Exchanges (FFEs) about grace periods for premium non-payment. The Bulletin addresses when grace periods related to terminations for premium non-payment fall across enrollment periods for the next benefit year. Issuers must provide a three-month grace period to Exchange enrollees who receive advance premium tax credits (APTCs), pay at least one month’s premium during the benefit year, and subsequently fail to pay their portion of the monthly premium. If the three-month grace period passes and the enrollee does not pay all outstanding premiums, the issuer must terminate the enrollee’s coverage, retroactive to the last day of the first month of the grace period. All other Exchange enrollees receive grace periods according to state law. The Bulletin explains the following for APTC recipients in FFEs:
Continue Reading CCIIO Issues New Guidance on Grace Periods for Non-payment of Premiums in Exchanges
Premiums
Third Party Payment of Qualified Health Plan Premiums Interim Final Rule
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Posted in Exchanges, Health Care Reform & ACA
The comment period closed today for an interim final rule that requires qualified health plans (QHPs) to accept premium and other cost sharing payments from certain federal and state programs and clarifies that failure to do so could result in a civil monetary penalty. The rule, promulgated on March 19th and effective on the same…
OMB Reviewing Regulations on Third-Party Payments to QHPs
By Troy A. Barsky on
Posted in Exchanges, Health Care Reform & ACA
An interim final rule addressing third-party premium payments to qualified health plans is under regulatory review at the Office of Management and Budget, according to an online posting on that agency’s website on March 4, 2014. Both providers and payors have anxiously watched for clarifications in this area following a series of conflicting statements from…