MEC Vs EHB Vs AV

[taterpeeler]

I've sent comments, but truthfully, HHS doesn't care. Even leaders in small towns accept public comments. But like Big Government, they follow their own internal agenda, regardless. IMO, it's just window dressing to make us THINK that they care.

It's sad that the country needs to experience huge premium increases to wake up and realize that ObamaCare won't work, but if that's what it takes..so be it!
-ac

I was one of those "leaders" in the 48th largest city in the country and with all due respect, I always listened to those comments during a public hearing so don't go there

 

[Yagents]

This puppy is no longer a 2000 page bill, it's now over 13,000 pages of regulations and growing.

 

[AllenChicago]

July 13, 2014

According to this most recent chart from the IRS, a Short Term Medical plan can be "Minimum Essential Coverage" (MEC), because it is "Health Insurance You Purchase from a Health Insurance Company directly."

CHART: Individual Shared Responsibility Provision - Minimum Essential Coverage

Is there some provision of the Affordable Care Act which excludes STM from being defined as "Health Insurance"? If so, then disregard this post.
ac

 

[rugerred]

That could be huge if true, , but they dont pay for preventive and have caps on payment. I was told that because they don't offer all of the EHB that made them unqualified.

Sent from my Samsung Galaxy

 

[RayNY]

Rugerred, I'm with you on this one. It doesn't qualify because of the limitations you outlined.

One could also contest that STM is "short term medical" insurance, not "health insurance" by definition.

http://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/mec-guidance-10-31-2013.pdf is some nice guidance on the criteria they use (45 CFR 156.604). Basically, it must meet "substantially all" of the standards set forth under that regulation.

Includes STM-excluding language, like "prohibition of annual and lifetime benefits", "guaranteed renewability". I'm sure someone could contest that an STM product is MEC, but good luck.

 

[AllenChicago]

Rugerred, I'm with you on this one. It doesn't qualify because of the limitations you outlined.

One could also contest that STM is "short term medical" insurance, not "health insurance" by definition.

http://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/mec-guidance-10-31-2013.pdf is some nice guidance on the criteria they use (45 CFR 156.604). Basically, it must meet "substantially all" of the standards set forth under that regulation.

Includes STM-excluding language, like "prohibition of annual and lifetime benefits", "guaranteed renewability". I'm sure someone could contest that an STM product is MEC, but good luck.

Every plan we have on the books that was written before this year is non-compliant with the ACA.

If the new IRS 1040 and supporting instructions don't do a better job of outlining what is/is not "health insurance", every STM policyholder in America will check the "Yes" box and enter their policy number. Just how deep into regulations does the law require your average taxpayer to delve?
ac

 

[rugerred]

Every plan we have on the books that was written before this year is non-compliant with the ACA.

If the new IRS 1040 and supporting instructions don't do a better job of outlining what is/is not "health insurance", every STM policyholder in America will check the "Yes" box and enter their policy number. Just how deep into regulations does the law require your average taxpayer to delve?
ac

Good point, but what I don't want to see is something coming back to bite them after the fact. My take is that they are noncompliant.

Sent from my Samsung Galaxy

 

[houcoogster]

July 13, 2014

According to this most recent chart from the IRS, a Short Term Medical plan can be "Minimum Essential Coverage" (MEC), because it is "Health Insurance You Purchase from a Health Insurance Company directly."

CHART: Individual Shared Responsibility Provision - Minimum Essential Coverage

Is there some provision of the Affordable Care Act which excludes STM from being defined as "Health Insurance"? If so, then disregard this post.
ac

Call up ehealth tell them you want to buy HI and your STM ended on 6-30-14 then say "can you help me out"?

 

[AllenChicago]

Call up ehealth tell them you want to buy HI and your STM ended on 6-30-14 then say "can you help me out"?

HouCoogster, for documentation purposes, I went the online CHAT route instead. E-healthinsurance chat told me that my Short Term Medical termination is not a qualifying event for triggering a Special Enrollment Period. I'd have to wait until 11/15/2014.

The owners of E-health would be upset with their guy if they knew that he didn't offer me a Short Term Medical to replace the one I'm losing at the end of this month! He must be an hourly employee, LOL.
-AC

 

[RayNY]

Every plan we have on the books that was written before this year is non-compliant with the ACA.

If the new IRS 1040 and supporting instructions don't do a better job of outlining what is/is not "health insurance", every STM policyholder in America will check the "Yes" box and enter their policy number. Just how deep into regulations does the law require your average taxpayer to delve?
ac

Enter policy number. IRS checks it (don't forget, thanks to the HUB, they have direct carrier system access) and discovers it's non-compliant. They process it properly, as if the "no" box was checked and issue the penalty.

Remember, people claim their pets as dependents and all sorts of wacky stuff. IRS has people whose full time job is sifting through the crap to find the facts. There are going to be hundreds of thousands, if not millions, submitted with errors, just like there is every other year.