The Centers for Medicare and Medicaid Services (CMS) issued a memo that it will extend the transitional policy for two years, for policy years beginning on, after or before Oct. 1, 2016, with the possibility of adding a one year extension then, if appropriate.
The transitional relief also applies to large businesses that currently purchase insurance in the large group market if, as of Jan. 1, 2016, they will be redefined by the Affordable Care Act (ACA) as small businesses purchasing insurance in the small group market.
As with the earlier transitional relief policy, State governments and health insurance issuers will have the option to offer the transitional relief or not participate.
Policies offered under the transitional relief will not be considered out of compliance with certain ACA market reforms, such as:
- Adjusted community rating for health insurance premiums
- Guaranteed availability of coverage
- Guaranteed renewability of coverage
- Prohibition of pre-existing conditions exclusions in the individual market
- Coverage of the 10 Essential Health Benefits categories established by the ACA
- Clinical trials participation
- Non-discrimination with respect to health care providers
