HHS
The U.S. Department of Health and Human Services (HHS) published the 2014 Federal Poverty Levels (FPL) last week. The 2014 FPL guidelines have been raised 1.5% in comparison to the 2013 FPL. The FPL is a measure of income used to determine eligibility for various government programs including healthcare, housing and food stamps. The FPL is also used as part of the Affordable Care Act (ACA) to determine eligibility for subsidies available through the Health Insurance Marketplace, also known as the Exchange.
The U.S. Department of Health and Human Services (HHS) published a report earlier this week with details about enrollment numbers and other information as it relates to state and federal insurance exchanges. Below is a list of some key information that was included in the report.
The U.S. Department of Health and Human Services (HHS) has announced that self-funded health plans will be exempt from the reinsurance fees after the first year. The recent announcement is expected to be published in a forthcoming document with other rule modifications.
Section 3210 of the Affordable Care Act (ACA) required nominal cost sharing to be added to Medicare Supplement Plans C & F. Under the current structure these Medicare Supplement plans eliminate nearly all of the cost sharing that is associated with Original Medicare.
It has been a common belief by many people that Plans C & F cause excessive and unnecessary utilization as a result of the limited cost sharing. The expectation was that Section 3210 would modify Plans C & F to include some form of a front-end deductible to encourage more appropriate uses of physician services.
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.
Last week the U.S. Department of Health and Human Services (HHS) released proposed regulations about the role of Navigators. The new guidance provides some clarification about the role of Navigators, but it has several producers questioning how they will be compensated for their services next year.
Navigators are organizations that will provide unbiased information to consumers about health insurance.
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) 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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