On April 13, 2017, the Trump administration finalized a rule that the insurance industry hopes will curb the number of sicker people who sign up for coverage on the individual insurance exchanges.
These final regulations, effective June 19, 2017 intend to help stabilize the Health Insurance Marketplace, provide more flexibility to states and insurers, and give individual health plan consumers more coverage options.
These final rules make the following policy changes:
- Shortened Open Enrollment Period The 2018 open enrollment period for the individual market will run from November 1, 2017, through December 15, 2017, which more closely aligns with open enrollment for Medicare and the private market.
- Greater Control over Special Enrollment Periods The rules expand verification of eligibility for special enrollment periods in Marketplaces, limit the ability of Marketplace enrollees to change plan metal levels during the coverage year, and adjust requirements for special enrollments due to marriage.
- Promote Continuous Coverage Issuers will be allowed to collect premiums for unpaid coverage within the past year before re-enrolling individuals for the next year to promote continuous coverage.
- More Consumer Choice To help provide enrollees with more coverage options, beginning with 2018 plans, issuers will have greater actuarial value flexibility to offer more lower-cost choices and to continue offering existing plan options.
- Empower States for Network Adequacy and Plan Design CMS will defer oversight of network adequacy and health plan certification to states that have sufficient review processes to determine adequacy for their residents.
Read the CMS news article for more details.