SEPs

After both the Washington HealthPlan Finder and Pennsylvania's Pennie ACA exchange announced that they were setting up Special Enrollment Periods for residents who were scammed by Benefytt Technologies into buying non-ACA compliant heatlhcare policies, this shouldn't be surprising.

via Amy Lotven of Inside Health Policy (paywall):

Pennie Logo

A couple of weeks ago I noted that the Washington HealthPlan Finder has launched a special enrollment period for several hundred WA residents who were misled into enrolling in non-ACA compliant healthcare policies via fraudulent marketing by a company called "Benefytt Technologies."

Last week Pennie, Pennsylvania's ACA exchange followed suit:

The Federal Trade Commission Took Action Against Benefytt Technologies for Providing Deceptive Health Plans – Pennie is Helping Impacted Pennsylvanians Enroll in Quality Coverage  

Washington HealthPlan Finder

via the Washington Health Benefit Exchange:

FTC action against Benefytt results in refunds for consumers who bought insufficient plansOlympia, WA

Washington Health Benefit Exchange (Exchange) is opening a special enrollment period until Nov. 10, 2022, for 232 Washingtonians who were sold an insufficient healthcare plan from Benefytt Technologies.

Benefytt must contact customers who are currently paying for Benefytt’s plans, inform them of the Federal Trade Commission’s (FTC) complaint against the company, and allow them to cancel their enrollment. Benefytt also must provide refunds for payments made after the order is entered directly to customers who cancel right away.

CMS Logo

via the Centers for Medicare & Medicaid Services:

Today, the Centers for Medicare & Medicaid Services (CMS) posted Frequently Asked Questions (FAQs) regarding compensation paid by issuers to agents and brokers who assist consumers with enrollment during a Special Enrollment Period (SEP) or during Open Enrollment Periods (OEPs). The Biden-Harris Administration has made it a priority to provide those who are uninsured and underinsured with quality, affordable health care coverage and recognizes that agents and brokers play a vital role in helping consumers enroll in coverage that best fits their needs and budget.

ACA Signups Logo

Last week the Centers for Medicare & Medicaid posted a new press release about a new report from the HHS's Assistant Secretary for Planning & Evaluation (ASPE) which has updated ACA-specific enrollment data current as of October 2021 - March 2022:

New Reports Show Record 35 Million People Enrolled in Coverage Related to the Affordable Care Act, with Historic 21 Million People Enrolled in Medicaid Expansion Coverage

ACA Signups Logo

Last June, the U.S. Health & Human Services Dept. confirmed my estimate that total enrollment in healthcare policies either specifically created by (or expanded to more people by) the Affordable Care Act had broken 31 million Americans:

Today, the U.S. Department of Health and Human Services (HHS) released a new report that shows 31 million Americans have health coverage through the Affordable Care Act – a record. The report also shows that there have been reductions in uninsurance rates in every state in the country since the law’s coverage expansions took effect. People served by the health Marketplaces and Medicaid expansion have reached record highs.

HHS's breakout was fairly close to mine, though they had enrollment a bit higher in some categories and a bit lower in others:

And there it is:

CMS Logo

The Affordable Care Act includes a long list of codified instructions about what's required under the law. However, like any major piece of legislation, many of the specific details are left up to the agency responsible for implementing the law.

While the PPACA is itself a lengthy document, it would have to be several times longer yet in order to cover every conceivable detail involved in operating the ACA exchanges, Medicaid expansion and so forth. The major provisions of the ACA fall under the Department of Health & Human Services (HHS), and within that, the Centers for Medicare & Medicaid (CMS)

Every year, CMS issues a long, wonky document called the Notice of Benefit & Payment Parameters (NBPP) for the Affordable Care Act. This is basically a list of tweaks to some of the specifics of how the ACA is actually implemented.

This morning, CMS issued the final NBPP for the upcoming 2023 Open Enrollment Period. Since there's so many provisions included, this year I've decided to break it into multiple posts which only focus on one or a few of them at a time:

Access Health CT Logo

via Access Health CT:

Access Health CT Announces New Special Enrollment Period for Connecticut Residents with Lower Income

HARTFORD, Conn. (April 25, 2022) — Access Health CT (AHCT) today announced a new Special Enrollment Period (SEP) for Connecticut residents with lower income beginning April 25. This new SEP will provide access to no- or very low-cost health insurance plans made possible by the American Rescue Plan Act (ARPA).

To be eligible for this SEP, Connecticut residents must:

  • Be new or returning customers who are not currently enrolled in a health insurance plan through Access Health CT.
  • Have a household income at or below 150% of the Federal Poverty Level (FPL). 

If you don't know what 150% FPL is, it depends on your household size:

Connect for Health Colorado Logo

via Connect for Health Colorado:

Here’s what you need to know about signing up for health coverage

DENVER — It’s Open Enrollment in Colorado. For those who aren’t already covered by job health insurance or another insurance program (like Health First Colorado, Colorado’s Medicaid program or Medicare), now is the time to sign up for a health insurance plan for 2022 coverage. This year, many individuals, families and small business owners shopping for health and dental plans can expect increased plan choice and savings for 2022.

Nevada Health Link Logo

Via Nevada Health Link:

More Plans, Carriers and Savings Available During Nevada Health Link’s Open Enrollment Period Starting Today

WHAT: Open enrollment begins today on NevadaHealthLink.com, the online health insurance marketplace operated by the state agency, the Silver State Health Insurance Exchange (Exchange), that connects Nevadans to quality, affordable health and dental plans. For this Plan Year 2022, Nevadans can shop 126 qualified health plans. All plans are designed to fit each individual’s budget and health needs.

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