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On September 17, 2021, the Centers for Medicare & Medicaid Services (CMS) finalized a series of provisions that follow through on President Biden’s commitment to build on the Affordable Care Act, expand health coverage access for Americans and advance health equity. The provisions are the third installment of the payment notice for 2022.
There are several important policy updates that Marketplace agents and brokers should be aware of prior to the beginning of the plan year 2022 Open Enrollment Period (OEP). These provisions include:
An extension of the OEP from November 1, 2021, to January 15, 2022, annually for Marketplaces on the federal platform.
Clarification for Special Enrollment Period (SEP) rules regarding enrollees who qualify for a maximum advance premium tax credit (APTC) amount of zero dollars.
A monthly SEP for APTC-eligible individuals whose household income does not exceed 150 percent of the federal poverty level (FPL).
Clarification on the full range of Direct Enrollment (DE) and Enhanced Direct Enrollment (EDE) options available for OEP. Note: DE and EDE will be fully available for the upcoming OEP, and in 2022, for Federally-facilitated Exchange (FFE) states. There are no changes to the current operations of the federal DE and EDE pathways.
This final rule demonstrates a strong commitment by the Biden-Harris Administration to expand health insurance coverage to more Americans and make it easier and more affordable to obtain coverage.
For more information on the final rule or to review the rule in its entirety, refer to the following resources:
CMS Press Release: https://www.cms.gov/.../cms-extends-open-enrollment...
Fact sheet: https://www.cms.gov/.../patient-protection-and-affordable...
Final Rule: https://www.cms.gov/.../cms-9906-f-nbpp-webposting...
There are several important policy updates that Marketplace agents and brokers should be aware of prior to the beginning of the plan year 2022 Open Enrollment Period (OEP). These provisions include:
An extension of the OEP from November 1, 2021, to January 15, 2022, annually for Marketplaces on the federal platform.
Clarification for Special Enrollment Period (SEP) rules regarding enrollees who qualify for a maximum advance premium tax credit (APTC) amount of zero dollars.
A monthly SEP for APTC-eligible individuals whose household income does not exceed 150 percent of the federal poverty level (FPL).
Clarification on the full range of Direct Enrollment (DE) and Enhanced Direct Enrollment (EDE) options available for OEP. Note: DE and EDE will be fully available for the upcoming OEP, and in 2022, for Federally-facilitated Exchange (FFE) states. There are no changes to the current operations of the federal DE and EDE pathways.
This final rule demonstrates a strong commitment by the Biden-Harris Administration to expand health insurance coverage to more Americans and make it easier and more affordable to obtain coverage.
For more information on the final rule or to review the rule in its entirety, refer to the following resources:
CMS Press Release: https://www.cms.gov/.../cms-extends-open-enrollment...
Fact sheet: https://www.cms.gov/.../patient-protection-and-affordable...
Final Rule: https://www.cms.gov/.../cms-9906-f-nbpp-webposting...
