15 Day Advance Termination Limitations

[cadylou]

Does anybody know why they implemented this 15 day rule?

I'm just wondering what function this serves, is it to ensure providers claims get paid or is it a system glitch or is it to allow the carriers more time to get the file from hc.gov.......I'm drawing a blank.

One other thing on this. I've wrote a whole lot of deals in every way possible and in not one of them have I read OR had read to me a disclaimer telling the client that they MUST give the Marketplace 15 days notice to cancel. So I'm not sure how legal any collection efforts would be.

I don't believe there's anything in writing, but I just experienced this where the marketplace tells the client "it takes 'about' two weeks". Sounds to me as if it's THEIR process that's broken. My client lost her subsidy & her premium went to $733/mo, which she cannot afford. She wanted to cancel & do short term. Unfortunately, the only company I have left offering short term is BCBS which is who she had the marketplace policy with. BCBS tells her that she can't have short term start until her 'termination' is complete.

So, they tell her she can either pay another $733 to stay covered, or go uninsured while they all fiddle around . . . .

What a mess. . . .Of course, since the "marketplace" people don't have to carry E&O or anything else, the consumer has no legal recourse if they are misled, or worse yet, left uninsured and then something horrible happens to them during that time. . . . .

 

[FLM2]

I don't believe there's anything in writing, but I just experienced this where the marketplace tells the client "it takes 'about' two weeks". Sounds to me as if it's THEIR process that's broken. My client lost her subsidy & her premium went to $733/mo, which she cannot afford. She wanted to cancel & do short term. Unfortunately, the only company I have left offering short term is BCBS which is who she had the marketplace policy with. BCBS tells her that she can't have short term start until her 'termination' is complete.

So, they tell her she can either pay another $733 to stay covered, or go uninsured while they all fiddle around . . . .

What a mess. . . .Of course, since the "marketplace" people don't have to carry E&O or anything else, the consumer has no legal recourse if they are misled, or worse yet, left uninsured and then something horrible happens to them during that time. . . . .

This is the no doubt the worst aspect of the law-the unintended loss of coverage for a month or more while migrating from one plan to another (or back to the same plan) because of a Marketplace determination change.

It could easily be fixed but there isn't enough outrage (yet) in the media-it will take a bunch of people getting screwed over by medical claims for this to get enough exposure-we just know it will happen because we see it every day.

 

[yorkriver1]

Yagents, same situation with client, 6/1 group insurance. Yesterday HC.gov read all these disclaimers "are you sure you are ok with insurance ending mid-month, etc". So weird, like we haven't backdated or matched cancellations to the date of new insurance replacement coverage, for, like, decades.

After I got off the phone, I called the carrier, who assured me with rep name and call reference #, that they would not take the insured to collections for unpaid premium for the 15 days. Just don't pay the bill. I may not have heard the last here, but we'll see.

Thanks for all the subsidy/tax info, from y'all. Now I will also flag the file to check in 2016 for 1095-A glitches. Really, though, that could happen to anyone who reports a life change and reduces/loses subsidy mid-year, too, it seems. This client had already had subsidy removed due to increased salary on new job starting in April.