Originally Posted by anonymous1
So when oct 1 starts the have Humana find a better plan get the subsidy ECt what ever. They fax the cancelation in then. That way Humana cannot renew and trap them in by default I'm not sure what I'm missing
So, let's take that example again, and use the method you mentioned above.
* The client has Humana.
* The client extends their Humana renewal to December 2014.
* Open enrollment in the year 2014 ends on December 7th, not March. (The March extension is only for the first open enrollment that begins 10/1/2013.)
* The client selects their ACA compliant plan, but it's not Humana. It's Aetna.
* Early in OE (let's say November), the client completes their enrollment in Aetna for an effective date of 1/1/2014.
* Humana is set to default auto enroll them on 12/30/2014 for a Humana ACA compliant plan.
* If the client doesn't do something to stop that default auto enrollment, then Humana's default auto enrollment will be an SEP (due to the current plan ending), and the client is stuck with it for a year, because they don't have another SEP available to them (unless the client can prove that the carrier or agent did something wrong and enrolled them in the wrong plan, which opens a new SEP).
* So, to avoid that, you are recommending that the client should fax a cancellation notice to Humana. When? Effective 12/29/2014 before the auto-enroll happens, and then takes a short-term plan for 2 days? Effective 12/1/2014 and takes a short-term plan for 31 days? That may be okay for a healthy and risk tolerable client, but not all clients. It seems to me that a form or letter instructing Humana to NOT default auto enroll them in a Humana ACA compliant plan is a better choice.
Let's even change that scenario from 2014 to 2013. Let's say the client does NOTHING about the Humana renewal strategy offer. So, the client is in group B where the renewal date is not delayed, and their plan must become ACA compliant 1/1/2014, if I understood today's webinar correctly. So, Humana auto enrolls them 12/31/2013 for an ACA plan effective 1/1/2014. The open enrollment extends to March 2015 this year, so they have time to change that, I think. Do they? If their plan became effective 1/1/2014, and they don't realize the error for a few weeks, can they still change plans in OE even though the first plan has been in effect for a few weeks? I know that CMS was saying they can change their mind, but how about after the policy is issued and effective? Maybe an MAPD
agent who deals with CMS a lot can answer that (I do group & IFP but not Medicare).