HHS To Allow Automatic Re-Enrollment Under ACA

The majority of those who enrolled in the Patient Protection and Affordable Care Act plans through the exchanges will be auto-enrolled in the same health plan they selected in 2014 this coming enrollment period, as well as receive the same subsidies, if applicable, the administration said Thursday.

The rule was proposed by the Centers for Medicare and Medicaid Services.

“As we plan for open enrollment in year two and continue to build a sustainable long-term system, we are committed to simplifying the experience for consumers by allowing auto-enrollment,” HHS Secretary Sylvia Mathews Burwell said in a news release. “We are working to streamline the process for consumers wishing to remain in their current plan.”

Basically, under the new guidelines, most of the law’s customers “would be able to renew subsidized health insurance coverage without filing an application and without going back to HealthCare.gov, the website that frustrated millions of consumers last fall.” New HHS Secretary Sylvia Mathews Burwell, who issued the rules Thursday, said, “We are working to streamline the process for consumers wishing to remain in their current plan.”

Grace Period Provided for Payment of Premiums

Question: Must health plans participating in the exchanges provide individuals who purchase subsidized insurance coverage through the exchanges a 90-day grace period before terminating the coverage for non-payment of the premiums?

Answer: Yes. Under 45 CFR 156.270, individuals who purchase subsidized coverage through the exchanges must be provided a 90-day grace period before their coverage is cancelled for non-payment.

IRS to propose rules clarifying ACA penalties

The Internal Revenue Service has drafted a collection of proposed regulations that could determine whether some taxpayers will owe fines for failing to get health coverage.

The individual mandate section in the Patient Protection and Affordable Care Act requires some taxpayers who fail to own a minimum amount of major medical coverage, or “minimum essential coverage,” to pay the fines.

Some sections in the proposed IRS regulations will exempt some people in limited-benefit government programs from paying the fines.

Those affected include state programs for the medically needy, Medicaid pilot programs, and two programs that give people some access to military health care services.

The IRS assumes many enrollees are confused.

Proposed Rule Eases Contraceptive Mandate for Non-Profit Religious Organizations

On February 1, 2013, the Departments of Health and Human Services announced a proposed rule that, according to an agency press release, lays out "how nonprofit religious organizations, such as nonprofit religious hospitals or institutions of higher education, that object to contraception on religious grounds can receive an accommodation that provides their enrollees separate contraceptive coverage, and with no co-pays, but at no cost to the religious organization."

Here's the HHS fact sheet and proposed rule.

Draft Application for Health Insurance Coverage

On January 25, 2013, the Centers for Medicare and Medicaid Services (CMS) released draft versions of online and paper applications which consumers will fill out to buy policies in the new health insurance marketplaces, which are slated to begin enrolling people in October.

Drafts of the paper application and a 60-page description of the online version were quietly posted online by the Health and Human Services Department, seeking feedback from industry and consumer groups via the paperwork reduction act (PRA). The government's draft application runs 15 pages for a three-person family. An outline of the online version has 21 steps, some with additional questions.

At least three major federal agencies, including the IRS, will scrutinize your application. Checking your identity, income and citizenship is supposed to happen in real time, if you apply online.

The government estimates its online application will take a half hour to complete, on average. If you need a break, or have to gather supporting documents, you can save your work and come back later. The paper application is estimated to take an average of 45 minutes.

CMS Video of Proposed Application

IRS Releases Proposed Regulations on the Employer Mandate

On December 28, 2012, the IRS issued 144 pages of proposed regulations addressing the employer “shared responsibility” mandate (aka Play or Pay mandate) in the Affordable Care Act. In addition, the IRS issued a FAQ summarizing major points of the regulations. Some of the highlights include:

HHS Issues Guidance re: Market Rules, Essential Health Benefits

On November 20, 2012, several Federal agencies released Proposed Rules on Patient Protection and Affordable Care Act (PPACA) provisions that will impact insurers and group health plans. The rules are subject to the notice and comment process, and the final rules may vary significantly.