Individuals
Most health insurance professionals have some familiarity about the government subsidies that will be available next year to eligible individuals. These subsidies will reduce insurance premiums and out-of-pocket medical expenses for those that qualify, and will only be available to individuals that enroll in coverage through health insurance marketplaces, also known as the public exchanges.
The Center for Medicare and Medicaid Services (CMS) issued a statement on April 30, 2013 that the public exchange applications, officially referred to as the Marketplace Consumer Applications, have been revised.
The Invidual Short Form is now just three pages in length. The Family Form is also said to have been reduced by about two-thirds its original length.
What will the exchanges look like? What are the exchange deadlines? How will subsidies and payments be processed? There constantly seems to be questions about the health insurance marketplaces, also known as the exchanges.
The Center for Medicare & Medicaid Services (CMS) released a progress fact sheet about the exchanges on April 22, 2013. This new information provides additional details about eligibility and enrollment, plan management, financial management, consumer support and more.
Like the popular television commercials with children explaining their theories on what’s better (when asked if more is better than less), they want more. The concept is that simple. People, in general, do not want to settle for less.
Small businesses want more from a program that is named the Small Business Health Options Program or SHOP exchange. The government, however, has stripped away the “options” (at least for a year). If you’re a worker for a small business employer who is offered the SHOP exchange, you really don’t have anything to “shop” around for.
The Obama administration announced last week that parts of the Small Business Health Options Program (SHOP) would be delayed until 2015. This announcement has created a lot of confusion in the market.
The SHOP will be a new health insurance marketplace to provide exchange-based coverage to small businesses with up to 50 employees in most states. The SHOP is still expected to be launched as planned in 2014, but one of its key components will be delayed until 2015.
Online insurance marketplace offers more choice and flexibility for small businesses struggling with increasing healthcare costs.
InsureXSolutions® today announced that Assurant®, Inc., Blue Cross® and Blue Shield® of Texas (BCBSTX) and Humana®, Inc. have joined the list of health insurance companies available through their private insurance exchange. The products from these three insurance carriers include individual health plans and offer a variety of premium and deductible options. Along side Aetna® and Blue Cross® and Blue Shield® of Illinois, the InsureXSolutions private exchange now features leading insurance companies in select markets.
The U.S. Department of Health and Human Services (HHS) and the Internal Revenue Service (IRS) have jointly issued rules that define affordable coverage. Employers and employees still have several questions about how this affects penalty calculations and subsidy eligibility.
The following offers some insight on these key issues:
The U.S. Department of Health and Human Services (HHS) has published a draft version of the individual application that will be used for public exchange enrollments starting on October 1, 2013. The application may be as long as 21 pages for some families.
Estimates indicate the online application process will take a minimum of 45 minutes to complete, and it could be even longer for individuals applying for coverage with dependents. Social Security Numbers, citizenship and residency status and employment and income verification are among the items that will need to be disclosed. A recent AP news article indicated the application process "could be as daunting as doing your taxes."
The U.S. Department of Health and Human Services (HHS) posted final regulations about the deductible and out-of-pocket limitations to the Federal Registrar on February 25, 2013. Section 1302(c) of the Affordable Care Act (ACA) specifies that the maximum deductible for a qualified insurance plan cannot exceed $2,000 for single coverage and $4,000 for family coverage.
The U.S. Department of Health and Human Services (HHS) released the final regulations about Essential Health Benefits (EHB) on February 20, 2013. The guidance defines the benefits that must be included with all fully insured plans sold inside and outside of the public exchanges in 2014. This will impact all individual health plans and most small group health plans. Grandfathered plans and self-insured plans are exempt from the EHB requirements; however, self-insured plans that cover any EHB must provide coverage without any annual or lifetime dollar limits.
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