Aetna - Off-Exchange Plans Avail to Dec 2014

[benwrigh]

Benwrigh, don't feel bad - we don't know here who the companies are that will be participating in the exchanges. I know some that have said they will not, but I got that information strictly via verbal conversations with my reps for those companies. The only one I know for sure that will be in the exchange is BCBS (of course . . .)

Yes, Anthem for sure here. I believe there are going to be a couple medicaid type providers as well. I assume these will be direct only. So, Anthem will probably be all I will have, exchange wise. All I know for sure is there will only be 3 carriers in my main geographic region.

 

[TxOnline]

True for all companies. Lose your existing coverage and obtain a QHP. It's a Special Enrollment situation. Allowed by HHS in a July rule. The key is "losing their coverage"...meaning a Major Medical policy through work, or individually owned.
ac

I give up, Allen.

I've searched & searched the forum (and the internet ...AND govt websites) for this July rule.
Please direct me.

The "rule" should (MIGHT) also give us more details about STM's....whether losing an STM qualifies as an SEP (or not).

 

[Ann H]

Look at the attached slide 21 from a CMS webinar. It explains SEP rules, and one of them is losing MEC (minimum essential coverage).

Also note that it clearly says a lapse doesn't qualify as a loss.

Also note that MEC technically must contain some ACA-compliant features, like 10 EHBs for instance, but that doesn't apply until the 2014 renewal date for non-grandfathered policies that are in force on 12/31/2013. So, if your non-grandfathered, non-ACA-compliant plan renews in 2014, and you therefore lose it, then it's an SEP

 

[TxOnline]

My dear, precious Ann!!!
You just don't know how valuable you've been to ME.

You are gaining credits in heaven if no where else!!!!!!!

Studying SEP's was one of my next projects.

HOW can I get a copy of that CMS webinar (slides)?
I guess I should have been attending more webinars (and neglecting other stuff more).

They EVEN give you the Speaker Notes!!!
...invaluable (for me)

God BLESS you, Ann!!!!!!!!!!!!!!!!!

 

[Ann H]

My dear, precious Ann!!!
You just don't know how valuable you've been to ME.

You are gaining credits in heaven if no where else!!!!!!!

Studying SEP's was one of my next projects.

HOW can I get a copy of that CMS webinar (slides)?
I guess I should have been attending more webinars (and neglecting other stuff more).

They EVEN give you the Speaker Notes!!!
...invaluable (for me)

God BLESS you, Ann!!!!!!!!!!!!!!!!!

Thanks for the kind words. See the attached link. I see that they are showing a July training (my slides were from May), and the slides are slightly different, but the speaker notes still references losing MEC as triggering an SEP.

It's in the "Overview of the Health Insurance Marketplace July 2013 presenter slides and slides with speaker notes" link on that webpage (link below).

Training materials & presentations | Marketplace.CMS.Gov

 

[TxOnline]

I give up, Allen.

I've searched & searched the forum (and the internet ...AND govt websites) for this July rule.
Please direct me.

The "rule" should (MIGHT) also give us more details about STM's....whether losing an STM qualifies as an SEP (or not).

Anyone find the July rule?

 

[anonymous1]

Next year when you non compliant Aca plan is suppose to renew you have to find a new plan Why do you think all the big carriers are switching their renewal dates to dec. that gives them almost a full year of premium

 

[FLM2]

This isn't rocket science or brain surgery-when someone loses their current Major Medical plan (not STM, not limited benefit plan) after March 31, 2014 due to the plan being terminated there will be an election period for a new ACA plan.

Once 2014 is over, this will go away and SEPs will be much more limited.

The Feds aren't going to get in the way of anyone enrolling in an ACA plan next year, they want as many as possible so the likelihood of anyone being declined because there wasn't a qualifying event is as close to zero as it could be.

 

[somarco]

I certainly can't trump Ann or Yagents, but here are some additional resources that may (or may not) be helpful.

SPECIAL SECTION: Health Insurance Reform

ObamaCare Health Insurance Rules, Regulations and Standards

https://www.ehealthinsurance.com/affordable-care-act/news/obamacare-countdown-step-5-2