CMS has issued final rules for the individual health insurance market for 2018. These rules apply to policies purchased on or off the marketplace.
- 2018 Annual Open Enrollment Period – The 2018 Open Enrollment period will start on Nov 1st and run through Dec 15th. Previously the open enrollment period was 90 days, Nov 1st through Jan 31st. The new rule shortens the Open Enrollment period to 45 days.
- Reduce Fraud, Waste, and Abuse – Requires individuals to submit supporting documentation for special enrollment periods and ensures that only those who are eligible are able to enroll. Encourages individuals to stay enrolled in coverage all year, reducing gaps in coverage and resulting in fewer mandate penalties and helping to lower premiums.
- Promotes Continuous Coverage – Promotes personal responsibility by allowing insurers to require individuals to pay back past due premiums before enrolling into a plan with the same issuer the following year. This is intended to address gaming the system and encouraging individuals to maintain continuous coverage throughout the year, which will have a positive impact on the risk pool.
- More Choices for Consumers – For the 2018 plan year and beyond, this rule allows insurers to develop more choices with lower premium options for consumers, and to continue offering existing plans
- Empowers States to Reduce Duplication – Reduces waste of taxpayer dollars by eliminating duplicative review of network adequacy by the Federal Government. The rule returns oversight of network adequacy to states, which are best positioned to evaluate it.
Recent statistics released by CMS and related to the Affordable Care Act, aka ObamaCare:
- Approximately one-third of counties in the U.S. have only one insurer participating in their exchange for 2017
- Five states have only one insurer participating in their exchange for 2017
- Approximately 500,000 fewer people selected a plan in the exchange open enrollment in 2017 than in 2016
- Many states saw double digit increases in their insurance premiums including, but not limited to:
- AZ – 116%
- OK – 69%
- TN – 63%
- AL – 58%
- PA – 53%
Keeping you informed.
Argeus Benefits Group LLC