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

[AllenChicago]

HELP! This could be a BIG DEAL if I'm interpreting it correctly. Check out the "Addendum" paragraph at the bottom of this one page letter from the Illinois Department of Insurance.
LINK: http://insurance.illinois.gov/cb/2013/CB2013-12a.pdf

Is this letter saying that companies who don't/didn't submit plan designs to the state of IL for off-exchange sales before Sept 1, 2013 have to accept all applicants, 365 days a year?

Sounds pretty mean-spirited by only giving a 10 day advance notice, doesn't it? If true, the companies that missed this deadline will be out of Illinois (or business) within a year.
ac

 

[stuy119]

HELP! This could be a BIG DEAL if I'm interpreting it correctly. Check out the "Addendum" paragraph at the bottom of this one page letter from the Illinois Department of Insurance.
LINK: http://insurance.illinois.gov/cb/2013/CB2013-12a.pdf

Is this letter saying that companies who don't/didn't submit plan designs to the state of IL for off-exchange sales before Sept 1, 2013 have to accept all applicants, 365 days a year?

Sounds pretty mean-spirited by only giving a 10 day advance notice, doesn't it? If true, the companies that missed this deadline will be out of Illinois (or business) within a year.
ac

The last sentence somewhat confirms that. Wow.

 

[leevena]

I agree. Seems like they dont want any competition.

 

[Ann H]

Holy Smokes Batman. That is what it says. It's a huge issue.

 

[AllenChicago]

Stuy, Lee and Ann, thanks for your confirmations. I wonder if these state memos and letters are actually mailed to the insurance companies (e-mail and/or snail mail), or is it the insurers responsibility to check every state's website daily to see these things?

When I called Aetna, UnitedHealth and Humana in June to ask them if they were aware of the State of IL letter directing them NOT to manipulate plan year renewal dates, each company said that they were not aware of this 4/29/13 directive.

Also, when a new rule or directive is communicated via a letter, there's no hard and fast parameters associated with it. The public will likely never know of this directive from the IL DOI, and Insurers who know about this deadline, and missed it, certainly aren't going to communicate the 365-day open enrollment availability to agents, or anyone else.

However, I'm going to attempt to find out which companies missed the September 1st deadline for submitting off-exchange plans to the IL DOI, just in case it comes in useful after the 2013-2014 open enrollment period ends. Since Illinois cited Federal ACA Rules in issuing this directive, it's probably applicable to every state.
-ac

 

[RayNY]

I agree that's what it says. Weren't rates due half a year ago? They were supposed to be reviewed, debated, fixed, and released weeks ago. I recognize that off-exchange only had different guidelines, but is it still not due at least a quarter in advance?

Any carrier submitting rates now is behind the ball as it is. I think you'd see carriers pull product pretty quickly if they suddenly became the king of the adverse selection crowd.

 

[jstocking]

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.

-Allen

Maybe they can, but with many carriers axing their UW departments, that wouldn't fit their business model going forward and probably generate excessive negative press.

Just because something can be done, doesn't mean it should be done.

 

[AllenChicago]

I agree that's what it says. Weren't rates due half a year ago? They were supposed to be reviewed, debated, fixed, and released weeks ago. I recognize that off-exchange only had different guidelines, but is it still not due at least a quarter in advance?

Any carrier submitting rates now is behind the ball as it is. I think you'd see carriers pull product pretty quickly if they suddenly became the king of the adverse selection crowd.

Would have been nice if they could. We wouldn't be waiting for so much rate/plan information now. Unfortunately, HHS was still pumping out plan rules and guidelines as recently as July 2013. Companies had to incorporate all that guidance into their plan designs.
ac

 

[leevena]

Maybe they can, but with many carriers axing their UW departments, that wouldn't fit their business model going forward and probably generate excessive negative press.

Just because something can be done, doesn't mean it should be done.

No offense, but your comment about underwriting departments is a little off. With the introduction of community-rating, the need for an underwriter has been eliminated.

 

[lisamc]

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.


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

You are misinterpreting what you have read. Your link does not indicate someone can enroll during time periods not designated as the "Open Enrollment" period, instead the link is explaining how your policy effective date will be determined when you enroll only in the Open Enrollment period. It is very clear. If you enroll on a non-exchange plan, you can choose either the 1st or 15th as your effective date and, if you enroll say on November 30th you could be effective December 1st. However, if you are enrolling in a marketplace plan, your effective date is determined on when during the month you enroll. Makes sense since the carrier would need more than a day to send in your subsidy money to the carrier.

Your interpretation, if correct, would defeat part of the purpose of the reform, to prevent people from jumping on and off a plan when they needed it.