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News & Info Related To 2017 Open Enrollment
- Thread starter AllenChicago
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Welcome to the forum..you must be new.
- Thread starter
- #42
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FYI...The maximum OOP increases to $7,150 Indiv /$14,300 family on January 1, 2017.
Another piece of crap buried in regulations-why isn't MOOP tied to the cost of living increases rather than just adding 5-10% each year?
I don't need an answer for that, it's pretty obvious (even higher rate increases) but just another display of contempt for the American public.
Oh.......the lipstick gets thicker on this pig:
Maybe rates will stay level next year? We're really at the bursting point on premiums vs monthly budgets.
http://www.modernhealthcare.com/art...-forgoing-13-9-billion-from-aca-insurance-tax
Feds forgoing $13.9 billion from ACA insurance tax
By Bob Herman | March 1, 2016
Congress' decision to suspend the Affordable Care Act's tax on health insurers for one year will cost the government $13.9 billion, funding that normally would go to cover subsidies for low-income enrollees and other functions of the law.
The CMS, therefore, expects insurance companies to keep their premiums in check when they file 2017 rates this spring. The hope is the one-year tax reprieve will put a ceiling on premium increases and push savings to consumers instead of into the coffers of health insurers.
"Because the fee is not being collected for the 2017 fee year, administrative costs for plans in all impacted markets are expected to be adjusted appropriately to account for the moratorium," the CMS said in a document posted Monday.
Members of the Republican Congress embedded the one-year freeze of the tax in the year-end omnibus budget bill, along with two-year delays of the ACA's medical device tax and "Cadillac" tax on high-cost employer plans. The ACA imposed the taxes to seed money for other parts of the law.
Maybe rates will stay level next year? We're really at the bursting point on premiums vs monthly budgets.
http://www.modernhealthcare.com/art...-forgoing-13-9-billion-from-aca-insurance-tax
Feds forgoing $13.9 billion from ACA insurance tax
By Bob Herman | March 1, 2016
Congress' decision to suspend the Affordable Care Act's tax on health insurers for one year will cost the government $13.9 billion, funding that normally would go to cover subsidies for low-income enrollees and other functions of the law.
The CMS, therefore, expects insurance companies to keep their premiums in check when they file 2017 rates this spring. The hope is the one-year tax reprieve will put a ceiling on premium increases and push savings to consumers instead of into the coffers of health insurers.
"Because the fee is not being collected for the 2017 fee year, administrative costs for plans in all impacted markets are expected to be adjusted appropriately to account for the moratorium," the CMS said in a document posted Monday.
Members of the Republican Congress embedded the one-year freeze of the tax in the year-end omnibus budget bill, along with two-year delays of the ACA's medical device tax and "Cadillac" tax on high-cost employer plans. The ACA imposed the taxes to seed money for other parts of the law.
- 948
Yes - they do not care. They figure by then - agents will certainly be out of it & the public at large will be forced to fight their way through the process on their own somehow in that timeframe . . . .pathetic.
More.............
Marketplace Automatic Reenrollment
If the plan in which an individual is currently enrolled is no longer available, Marketplaces may enroll consumers in a plan offered by another insurer if the current insurer does not have a plan available for reenrollment through the Marketplace.
Network Adequacy Standards
Coverage when a provider leaves the network – New continuity-of-care requirements will apply in the Federal Marketplace. Insurers must provide 30 days' advance notice to patients receiving treatment from a provider who is leaving the network. Insurers will have to continue in-network coverage for individuals receiving active treatment, until the treatment is complete or for 90 days, whichever occurs first.
Treating certain out-of-network expenses as in-network – Beginning in 2018, cost-sharing amounts for certain services performed by out-of-network ancillary providers (e.g. anesthesiologists) at in-network facilities must be counted toward the in-network, annual out-of-pocket maximum. Only when the insurer provides written notice to the patient – at least 48 hours prior to the time of service – may the out-of-network service be billed at an additional cost. This is intended to help limit "surprise bills" for consumers.
Standardized Plan Options in the Individual Marketplace
The standardized plan system will remain in place to make it easier for consumers to compare costs for similar plans offered by different insurers in the Federal Marketplace. The current proposal includes four silver, one bronze and one gold plan. The standardized plans have:
Standard deductible amounts
Four-tier drug formularies
Only one in-network provider tier
Some services, such as office visits, urgent care and generic drugs, not subject to the deductible
A preference for copayments over coinsurance
Insurers can choose to offer standardized plans, non-standardized plans or both. Standardized plans will be displayed on HealthCare.gov in a manner intended to make them easy for consumers to find.
Navigator Responsibilities Beyond Enrollment
Beginning in 2018, Navigators will be required to provide post-enrollment assistance for functions such as Marketplace eligibility appeals, application for exemptions through the Marketplace, and helping consumers understand how to use their benefits. Navigators will also be required to assist vulnerable and underserved populations, as identified by the state-based exchange in their area.
Marketplace Enrollment Directly on Broker and Insurer Websites Delayed until 2018
Beginning in 2018, individuals may enroll in Marketplace coverage directly through an insurer or broker's website. Further guidance and requirements will be issued. Until then, the current Marketplace enrollment process will continue.
Marketplace Automatic Reenrollment
If the plan in which an individual is currently enrolled is no longer available, Marketplaces may enroll consumers in a plan offered by another insurer if the current insurer does not have a plan available for reenrollment through the Marketplace.
Network Adequacy Standards
Coverage when a provider leaves the network – New continuity-of-care requirements will apply in the Federal Marketplace. Insurers must provide 30 days' advance notice to patients receiving treatment from a provider who is leaving the network. Insurers will have to continue in-network coverage for individuals receiving active treatment, until the treatment is complete or for 90 days, whichever occurs first.
Treating certain out-of-network expenses as in-network – Beginning in 2018, cost-sharing amounts for certain services performed by out-of-network ancillary providers (e.g. anesthesiologists) at in-network facilities must be counted toward the in-network, annual out-of-pocket maximum. Only when the insurer provides written notice to the patient – at least 48 hours prior to the time of service – may the out-of-network service be billed at an additional cost. This is intended to help limit "surprise bills" for consumers.
Standardized Plan Options in the Individual Marketplace
The standardized plan system will remain in place to make it easier for consumers to compare costs for similar plans offered by different insurers in the Federal Marketplace. The current proposal includes four silver, one bronze and one gold plan. The standardized plans have:
Standard deductible amounts
Four-tier drug formularies
Only one in-network provider tier
Some services, such as office visits, urgent care and generic drugs, not subject to the deductible
A preference for copayments over coinsurance
Insurers can choose to offer standardized plans, non-standardized plans or both. Standardized plans will be displayed on HealthCare.gov in a manner intended to make them easy for consumers to find.
Navigator Responsibilities Beyond Enrollment
Beginning in 2018, Navigators will be required to provide post-enrollment assistance for functions such as Marketplace eligibility appeals, application for exemptions through the Marketplace, and helping consumers understand how to use their benefits. Navigators will also be required to assist vulnerable and underserved populations, as identified by the state-based exchange in their area.
Marketplace Enrollment Directly on Broker and Insurer Websites Delayed until 2018
Beginning in 2018, individuals may enroll in Marketplace coverage directly through an insurer or broker's website. Further guidance and requirements will be issued. Until then, the current Marketplace enrollment process will continue.
HealthRisk
Expert
- 43
They think the HIP fee applied to all business lines is going to counter-balance the phase out of reinsurance in the individual market.
- 948
Automatic re-enrollment with another insurer? It's like insurance "roulette". Wow! How can that be legal to choose insurance for someone and they'll have to pay the bill?
Because the people that make the laws said so?
They already did it this year with co-ops that failed (Plan currently enrolled in no longer available, same scenario). I know in my state, anyone who didn't choose replacement coverage when Health Republic went under was just rolled into Excellus/MVP/Fidelis.
Fidelis got the lions share. Of course, the network is notably different.
- 948
I know - I guess I'm just still constantly surprised at how bad this can get . . . .not sure why I'm surprised at anything anymore, but . . . .it's just all so awful.
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