The federal government’s most recent attempt to stabilize the individual health insurance marketplace cuts the open enrollment period to six weeks from three months.
The Department of Health and Human Services published the final rule in the Federal Register today. The regulations take effect June 19.
The 2018 open enrollment period will be adjusted to align more closely with open enrollment for Medicare and the private market.
The next open enrollment period will start on Nov. 1, 2017, and run through Dec. 15, 2017, encouraging individuals to enroll in coverage prior to the beginning of the year. Previous open enrollment periods extended from Nov. 1 through Jan. 31.
In addition to shrinking the open enrollment period, the new regulations make it more difficult for consumers to gain coverage outside of that period. Insurers had complained that consumers were misusing special enrollment periods, often enrolling in coverage after they realize they will need medical services and then dropping coverage soon afterward.
The new rules require requires individuals who want to acquire coverage during special enrollment periods to submit supporting documentation to determine whether they are eligible to enroll outside the regular open enrollment. This is designed to ensure that only those who are eligible are able to enroll during the special periods.
The final rule allows issuers to require individuals to pay back past due premiums before enrolling into a plan with the same issuer the following year. This is intended to address gaming and encourage individuals to maintain continuous coverage throughout the year, which will have a positive impact on the risk pool.
Insurers also will be given flexibility to develop plans with lower premium options for consumers, and will be permitted to pay a lower percentage of medical costs.
The final rule may be found here: https://s3.amazonaws.com/public-inspection.federalregister.gov/2017-07712.pdf
Susan Rupe is managing editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected].
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