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Archives for 2014

Individuals with Pre-Existing Conditions May Be Entitled to a SEP

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Individuals who had pre-existing conditions and were enrolled in the Pre-Existing Condition Insurance Plan (PCIP) are now eligible for a special enrollment period (SEP). PCIP was a plan put in place by the Affordable Care Act for individuals who had pre-existing conditions and had previously been unable to obtain health insurance due to those pre-existing […] Read More »

CMS Issues Guidance on SEPs & COBRA

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Today, the Centers for Medicare & Medicaid Services (CMS) issued guidance on special enrollment periods (SEP) when a consumer has coverage under COBRA. Specifically, CMS addressed the issue of what constitutes a “hardship” for purposes of receiving a SEP. Additionally, for consumers who are presently enrolled in a plan through COBRA, CMS has granted a SEP […] Read More »

HHS Releases Enrollment Data

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Today, the Department of Health and Human Services (HHS) released the latest enrollment data through March 31 which was the official end of open enrollment. These numbers include enrollment from the federally facilitated marketplace as well as the numbers from the state-based marketplaces. To read the news release from HHS, click here. The specific reports […] Read More »

Churning – What is It & What Do I Need to Know?

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Now that the open enrollment period has closed completely, it’s time to discuss the circumstances of individuals that will come up during the year that will affect their eligibility for special enrollment periods (SEPs). One of the more unique situations that can occur is referred to as “churning.” This is when an individual’s income fluctuates […] Read More »

DC & Hawaii Extend Deadlines

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Previously, we reported that many of the states had extended the deadline for consumers to complete their application. Since then, two jurisdictions have provided additional extensions. Initially, DC Health Link was providing an extension until April 15, but they have since lengthened the extension to April 30. To read more, click here. Additionally, Hawaii gave no […] Read More »

March Enrollment Updates for State-Based Marketplaces

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Many states which were running their own state-based marketplace are now releasing the reports for their enrollment up through the March 31 deadline. Here are the links to some of those states’ reports: Colorado Connecticut District of Columbia Hawaii Kentucky Maryland Minnesota Nevada New York Rhode Island Read More »

Request for Applications for Missouri CACs

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Are you a Certified Application Counselor (CAC) in Missouri or are you assisting with enrollment in Missouri? Are you looking for funding for the 2014-15 enrollment cycle? The Missouri Foundation for Health has released a Request for Applications where they are inviting organizations to apply for funds to provide assistance to consumers in Missouri with […] Read More »

Healthcare.gov Extension until April 15

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What Does It Mean for the State-Based Marketplaces? Before the March 31 enrollment deadline, HHS had announced that consumers who started or attempted to start an enrollment application by the deadline would be given an extension of time to complete it. Last week, we posted an update on the specifics of that extension – that […] Read More »

CMS Issues Final Rule on 3rd Party Payments

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In February, we reported on guidance that the Centers for Medicare and Medicaid Services (CMS) issued related to qualified health plans accepting payments from a third-party. At issue had been whether or not insurance carriers could accept payments from a third party such as the Ryan White Program. The new regulations require qualified health plans […] Read More »