Can Buy Q.H.Plans 365 Days @ Year?

[AllenChicago]

The Agent CMS Exchange Certification course states that the only time a health insurer can not deny an applicant, due to health reasons, is during an "open enrollment", or a "special enrollment" period.

This implies that health insurers can still sell Qualified Health Plans, yet underwrite them as they do now, even when it's not an open, or special enrollment situation.

A cursory search of the internet indicates that yes, insurers can still write QHPlans year-around, but I wanted to know if any of you have heard anything from your Insurers regarding this subject? T.I.A.
-Allen

 

[Dave020]

I've heard the same from Quotit. I posed to Anthem and will let you know when I hear back.

AFAIK, a person is only GI during OEP or if they have some kind of SEP.

 

[AllenChicago]

I've heard the same from Quotit. I posed to Anthem and will let you know when I hear back.

AFAIK, a person is only GI during OEP or if they have some kind of SEP.

Right..that's my understanding too, Dave. But I was also assuming that major medical could only be sold during an open or special enrollment period.

However, the Exchange Certification coursework implies that major medical can be sold year-around. This would mean that people who aren't sick can buy it any time, just like they do now.

If so, the questions then become, what will the premiums be, and will QHP major medical only be purchasable outside of the exchange(s).
ac

 

[somarco]

I assume you are referencing 2014 effective dates. I thought Ocare eliminated ALL medical underwriting (except tobacco questions).

So if this is true, a carrier can medically underwrite outside of OEP or SEP, what rates do they use?

The rest of Ocare requires unisex and community rating.

 

[taterpeeler]

Curveball..... Wtf... Allen, never heard this before... If your current yo da man... Ann will be impressed since she is the master of all things legal

 

[bluediamond]

O'Care does eliminate uw. Companies can choose their open enrollments at different times of the year, but most will have theirs at the same time as govt.

 

[Dave020]

My Anthem BC source says they have not heard of this and are wanting to know the credibility of the source. Seems this may not be the case.

My original understanding was that once OEP closes unless you have some kind of SEP, you are locked out until the next OEP.

I will seek further clarification.

 

[Ann H]

If this is true, it is news to me. And, yes I would be impressed, Allen. At BCBSAZ meeting yesterday they said they were only selling at OE and SEP, but does that mean they CAN'T sell other times? I thought PPACA eliminated all medical underwriting or "cherry picking" as they state it, but I could be wrong. I can't wait to hear the answer!
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Sorry, I was writing that while Dave020 posted, so I didn't see his post until now.

 

[Yagents]

Would it make sense that if a healthy person wants to pay full price to avoid the penalty, they would have an avenue?

I assume we r not talking MM STM

 

[AllenChicago]

What I'm finding is that the Non-Exchange enrollment availability varies by carrier and by state. Although, as expected, the Non-Exchange plans must meet the minimum essential requirements for being health insurance.

For Example, here's a brochure from LifeWise in Washington State that (on page 2) says that Non-Exchange applicants can sign up at any time.
Link: https://www.lifewisewa.com/documents/012775_07-26-2013.pdf

I'll see what else I can dig up and add it to this message.
ac