OEP 2016 Changed to 11/1/2015 to 1/31/2016

[Ann H]

I received an email alert from NAHU saying that this afternoon, the government changed OEP dates again. They said the new dates are November 1, 2015 to January 31, 2016 instead of October 1, 2015 to December 15, 2015.

 

[G.Gordon]

That is great news if it is fact. A 30 day window to focus on Medicare would be nice.

 

[Ann H]

NAHU referenced this document - https://s3.amazonaws.com/public-inspection.federalregister.gov/2015-03751.pdf

Open Enrollment is discussed on pages 161 to 166, but this paragraph on page 162 sums it up.

We are finalizing the provisions only with regard to the 2016 benefit year, with a modification. In response to comments, at §155.410(e)(2), we are providing that for the benefit year beginning on January 1, 2016, the annual open enrollment period begins on November 1, 2015 and extends through January 31, 2016 (2 weeks earlier but the same length as the open enrollment period for the 2015 benefit year). Additionally, we have revised the proposed language at §155.410(f)(2) and added three paragraphs to require that for the 2016 benefit year, the Exchange must ensure that coverage is effective January 1, 2016, for QHP selections received by the Exchange on or before December 15, 2015, February 1, 2016, for QHP selections received by the Exchange from December 16, 2015, through January 15, 2016, or March 1, 2016, for QHP selections received by the Exchange from January 16, 2016, through January 31, 2016​

The document mentions comments from the public regarding overlap with Medicare OEP and group insurance OEPs. NAHU's email said they lobbied strongly on both points.

 

[rugerred]

I have seen a ton of chatter about them looking at tax season for the OEP. Nothing official but there were a lot of complaints about holidays and not knowing income. If they do anything about it is a completely different story.

 

[Yagents]

I scanned this other document to find:

Pg 24 - will require 3rd party access to network lists to build search tools.
pg 39 - drug list requirements
pg 46 - each carrier and Co-Op get their own acct manager
pg 48 - Agents no longer have to send FFM certs and user ID's to carriers, as they will have to check the publicly avail lists.
pg 50 - Agent naughty list will be published
Pg 52 - WBE's in 150 languages including website taglines. Will Health Sherpa now read " Salud Guia"?


http://newsmanager.commpartners.com...ownloads/2016_Letter_to_Issuers_2_20_2015.pdf

 

[rugerred]

I scanned this other document to find:

Pg 24 - will require 3rd party access to network lists to build search tools.
pg 39 - drug list requirements
pg 46 - each carrier and Co-Op get their own acct manager
pg 48 - Agents no longer have to send FFM certs and user ID's to carriers, as they will have to check the publicly avail lists.
pg 50 - Agent naughty list will be published
Pg 52 - WBE's in 150 languages including website taglines. Will Health Sherpa now read " Salud Guia"?

http://newsmanager.commpartners.com/linktrack.php?url=http%3A%2F%2Fwww.cms.gov%2FCCIIO%2FResources%2FRegulations-and-Guidance%2FDownloads%2F2016_Letter_to_Issuers_2_20_2015.pdf

Speaking of drug lists, that was a quick lesson to check the formulary for clients and became another piece of the puzzle. This year there were a bunch of issues at least in Wisconsin. Some diabetic drugs covered others not and some pretty popular drugs not covered. It is getting as bad as PDP's matching drugs to carrier.

 

[G.Gordon]

Step therapy kicked my butt this year. Frustrating. If someone is uninsured they don't have much room to bitch, but it can sure keep a person from leaving a plan without that restriction.

 

[kgmom219]

Which means that we have 45 days to "touch" every current client for 1/1. Instead of 75. And it goes over Christmas. Not happy.

Long term, they need to bite the bullet and move it to 2/1 to 6/15 for a 7/1. Move everything to a 7/1 contract year (ded, coins, oop's) and use the previous years MAGI to determine the subsidy. Eliminates the clawback, the income guesstimate, income verification.

Whats the agent naughty list? Can I nominate people I don't like to get added?

 

[rugerred]

Technology made great strides but then the meds kicked me back. making the OEP shorter makes no sense, not to mention you lose at least 3 days each over Christmas and thanksgiving. These people just don't listen or learn from mistakes.

 

[AllenChicago]

If the Supreme Court doesn't blow ObamaCare out of the water, they'll extend enrollment to the end of April 2016. There will still be millions of uninsured who didn't know the penalty increased from 1% to 2%.