CMS has released a final rule containing standards for health insurers selling coverage through the Patient Protection and Affordable Care Act exchanges in 2015.
A fact sheet on the standards includes a bulletin on the second extension of health plans that don't comply with PPACA requirements. The White House announced last week that consumers will now be able to renew non-PPACA compliant plans through Oct. 1, 2016, which means some of the old policies will still be in effect in 2017. Originally, non-grandfathered policies — plans that went into effect or underwent certain changes after the PPACA became law in March 2010 — had to meet new coverage requirements in 2014. Late last year, President Barack Obama decided to let health insurers continue offering plans that don't meet the reform law's requirements through the end of this year.
CMS' final rule also contains benefit and payment parameters for 2015 concerning premium stabilization, open enrollment, annual limitations on cost sharing, consumer protections, financial oversight and the Small Business Health Options program.
The rule includes a $44 per capita rate for the 2015 transitional reinsurance fee, down from $63 in 2014. It also lowers the threshold for reinsurance payments from $60,000 to $45,000 for the 2014 benefit year, based on updated estimates. The PPACA reinsurance program seeks to stabilize the market by collecting funds to offset the expenses of health plans that enroll higher-cost individuals.
The rule also establishes that the 2015 open enrollment period will begin Nov. 15 and run through Feb. 15, 2015. It also implements a state-level adjustment to the temporary risk corridors program, which limits health plans' losses and gains beyond a specified range to stabilize premiums and prevent inaccurate premium setting during the early years of the PPACA exchanges.
For more information, read the full CMS final rule fact sheet here.
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