More healthcare-related regulatory news for plan sponsors, including links to detailed information.
CMS issues FAQs on health insurance market reforms and marketplace standards
The Centers for Medicare and Medicaid Services (CMS) issued a set of frequently asked questions (FAQs) on health insurance market reforms and marketplace standards that provide guidance on the implementation of the essential health benefits and on actuarial value, guaranteed availability, minimum essential coverage, and transitional policy extensions.
As it relates to employers, the guidance answers:
• Can a health insurance issuer file a plan for state approval in the individual or small group market that is intended to be offered only as a qualified health plan in the marketplace?
• Would a large employer with 51 to 100 employees that is a large group policyholder be covered by the March 5, 2014, bulletin with respect to a renewal of its 2013 plan at its 2014 renewal date if the policy is not compliant with the provisions of the Patient Protection and Affordable Care Act (ACA) that apply to the large group market?
• Is a large group employer who employs 51 to 100 employees required to remain with the same insurer between 2013 and 2016 in order to be eligible for transitional relief in 2016?
• Are individual policyholders and small employers who changed carriers between October 2, 2013, and December 31, 2013, eligible for extended transitional relief?
• If an individual or small employer purchased a 2014 ACA-compliant plan, are there circumstances where the policyholder can have the 2013 plan reinstated and be eligible for the transitional policy relief?
• Does the large employer transitional policy starting in 2016 apply to large employers with 51 to 100 employees that did not have health insurance coverage at the time the transitional policy extension bulletin was issued March 5, 2014, but who purchase a large employer policy after March 5, 2014, but before January 1, 2016?
To read the entire FAQ guidance, click here.