Smart Benefits: Beware - Documentation Needed for Marketplace Special Enrollment Periods
Monday, September 12, 2016
In an FAQ issued last week on an element in HHS’ Proposed Notice of Benefit and Payment Parameters for 2018 about reducing abuse of Federal marketplace special enrollment periods, HHS said it’s committed to ensuring the availability of the periods for eligible individuals – but equally committed to avoiding any misuse.
To curb abuse, HHS explains that it has taken a number of steps, including:
added warnings to HealthCare.gov against the inappropriate use of special enrollment periods
eliminated certain special enrollment periods that are no longer needed
tightened the eligibility rules for certain special enrollment periods
Most significantly, HHS has introduced a special enrollment confirmation process that requires consumers enrolling through the most common special enrollment periods in a Federal marketplace to provide documentation to confirm their eligibility.
HHS reports that preliminary data shows this new confirmation process may be responsible for a material decrease in special enrollment period plan selections. In fact, in the seven weeks after implementation of the confirmation process, special enrollment period plan selections in 2016 were almost 15 percent lower than during the same weeks last year.
Rob Calise is the Managing Director, Employee Benefits. of Cornerstone|Gencorp, where he helps clients control the costs of employee benefits by focusing on consumer driven strategies and on how to best utilize the tax savings tools the government provides. Rob serves as Chairman of the Board of United Benefit Advisors, and is a board member of the Blue Cross & Blue Shield of RI Broker Advisory Board, United HealthCare of New England Broker Advisory Board and Rhode Island Business Healthcare Advisors Council. He is also a member of the National Association of Health Underwriters (NAHU), American Health Insurance Association (AHIA) and the Employers Council on Flexible Compensation (ECFC), as well as various human resource associations. Rob is a graduate of Bryant University with a BS in Finance.
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