Trump Administration Releases Final Rule and Fact Sheet Regarding Short-Term Limited Duration Insurance

The Trump Administration issued a final rule Wednesday morning regarding short-term plans (or STPs) that is expected to go into effect 60 days from today. The rule will end a policy from the Obama Administration that restricted the length of time for STPs. The final rule restores the maximum duration of STPs to up to 364 days, with the ability to renew for up to 36 months at the carrier’s discretion.

The rule was created in response to an executive order passed by President Trump in October that directed federal agencies to expand the availability of Association Health Plans, short-term policies, and HRAs.

Click here to view the final rule.

Click here to view the fact sheet.

 

Contact your Cornerstone representative for any additional details.

CMS Mailing New Medicare Cards to Wave 4 States

The Centers for Medicare and Medicaid Services started mailing new Medicare cards to people with Medicare who live in Wave 4 states: Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Rhode Island, and Vermont. CMS will continue to mail new cards to people who live in Wave 3 states, as well as nationwide to people who are new to Medicare.

CMS finished mailing cards to people with Medicare who live in Wave 1 and Wave 2 states and territories (Alaska, American Samoa, California, Delaware, District of Columbia, Guam, Hawaii, Maryland, Northern Mariana Islands, Pennsylvania, Oregon, Virginia, and West Virginia). If someone with Medicare says they did not get a card, print and give them the “Still Waiting for Your New Card?” handout (in English or Spanish) or instruct them to:

  • Sign into MyMedicare.gov to see if we mailed their card. If so, they can print an official card. They need to create an account if they do not already have one
  • Call 1-800-MEDICARE (1-800-633-4227). There might be something that needs to be corrected, such as updating their mailing address.

via Medicare Learning Network

CMS Releases Exchanges Trends Report

CMS recently released a report outlining the current condition of the operational and programmatic
aspects of the Exchanges.

Key Highlights:

  • For plan year 2018, 49,100 agents and brokers registered with Federal platform Exchanges, supporting 42 percent of overall enrollments.
  • The cost breakdown for registration/training, technical assistance, and oversight is $2.40 per enrollee.
  • The biggest concerns for agents and brokers are lack of competition in the individual market and availability of commissions from insurance carriers.
  • To date, CMS has implemented 93 percent of recommendations from our agent and broker partners

Click here to view the full Trend Report from CMS.

CMS to Suspend ACA Risk-Adjustment Payments

The Centers for Medicare & Medicaid Services announced that a months-old federal court ruling will force it to suspend risk-adjustment payments, worth about $10.4 billion for 2017. These payments are meant to help balance the insurance markets when some insurers had to take on sicker, more costly patients.

 

For more information, click here.

Upcoming Marketplace Learning Management System Closure

The Marketplace Learning Management System (MLMS) will be closed starting July 18 at 6:00 PM ET until training for plan year 2019 goes live.

Before this “go-dark” period begins on July 18 at 6:00 PM ET, you should:

  • Check that your MLMS profile is up-to-date.
  • Print your Registration Completion Certificate(s) to document your plan year 2018 registration for the Individual and/or Small Business Health Options Program (SHOP) Marketplace.

Certificates showing you have completed plan year 2018 registration and training will not be available after the MLMS closes.

To print your plan year 2018 Registration Completion Certificate(s), follow these three steps:

  1. Log in to the CMS Enterprise Portal.
  2. On the “My Status” page, the “Complete Agent Broker Training” entry will show “Complete” in the “Status” column if you have completed training.

Select the “Print Certificate(s)” link and follow the prompts.

During the go-dark period, the Centers for Medicare & Medicaid Services (CMS) will be preparing for plan year 2019 registration and training. Stay tuned for updates, or visit the Resources for Agents and Brokers webpage.

 

Contact your Cornerstone representative with any questions.

 

RESOURCES

Take Note: Upcoming MLMS Closure

CMS Releases HHS Notice of Benefit and Payment Parameters for 2019

CMS recently issued the HHS Notice of Benefit and Payment Parameters for 2019, generally for plan years beginning on or after January 1, 2019. The rule is designed to improve affordability for those with high premiums.

The rule includes provisions in the following key areas:

  • Essential Health Benefits (EHB)
  • Qualified Health Plan (QHP) Certification Standards
  • Exemptions
  • Risk Adjustment
  • Advance Premium Tax Credit (APTC) Program Integrity
  • Special Enrollment Periods (SEPs)
  • Medical Loss Ratio
  • Small Business Health Options Program (SHOP)
  • Rate Review

In addition, CMS has extended the transitional policy for one additional year, allowing for the transition to fully ACA-compliant coverage in the individual and small group Health Insurance Marketplaces until 2019.

Click here for more information or contact your Cornerstone representative.

 

ADDITIONAL RESOURCES

States face challenge in curbing premiums after stabilization package fails

CMS issues final 2019 Payment Notice Rule to increase access to affordable health plans for Americans suffering from high Obamacare premiums

CMS to Review Resources for Marketplace Agents and Brokers

On March 15, 2018, CMS will host a webinar that provides an overview of the Agents and Brokers Resources webpage, as well as a new search tool that facilitates finding the appropriate resources on that page. The webinar will review other online resources, like Help Desks, and Call Centers, that are available to Marketplace agents and brokers, and will cover best practices for troubleshooting technical issues.

To register for this webinar, please visit www.REGTAP.info and register for “2018 Health Insurance Marketplace Updates for Agents and Brokers.”

DATE: Thursday March 15, 2018

TIME: 2:00 pm–3:00 pm ET

Click here for more information.

Medicare Clients to Receive New Cards Starting April 2018

Medicare has a major change coming this year and I want to make sure you are aware. The Centers for Medicare and Medicaid Services (CMS) will be replacing all members’ cards starting in April 2018. They are replacing the cards based on a provision in the Medicare and CHIP Reauthorization Act of 2015 (MACRA). MACRA section 501 requires CMS to remove Social Security numbers (SSN) from Medicare cards and to replace the use of SSNs with new, randomly generated Medicare beneficiary identifiers, or MBIs by April 2019, to protect the individual’s identity.

This massive card replacement will affect clients who use Medicare Supplement Insurance to fill in the gaps in their Medicare Part A and Part B coverage. Individuals insured with a Medicare Advantage plan will also get new original Medicare cards, but they should continue to use their Medicare Advantage plan cards when seeking medical care.

The new cards will look just like they have in the past with a red, white, and blue palette, except these cards will not include the individual’s SSN, and will instead have a Medicare number. The MBI on their Medicare card includes both numbers and letters for optimal security. See below what the new cards will look like with the new MBI number:

Starting April 2018, newly eligible beneficiaries will get a card with a unique number regardless of where they live. For those individuals who currently have a Medicare card, CMS will begin mailing new Medicare cards over a period of approximately 12 months based on geographic location and some other factors. Ohio and Kentucky will be of the last states to get the new cards. Below is a chart that shows, based on the area, when individuals will receive their new card:

Beginning in April 2018, individuals with Medicare will be able to go to Medicare.gov/newcard to sign up for emails about the card mailing and to check the card mailing status in their state. Individuals may use their card immediately upon receiving it. They will be able to use either the SSN-based or the new random alphanumeric-based numbers through December 2019. Beginning January 1, 2020, only the new cards will be accepted.

With any change in Medicare comes confusion. This is a great opportunity to reach out to your clients to explain any changes and what they can expect. Click here for a one-page flyer from CMS that outlines the details of the new Medicare card. This is a great reference for your clients.

Trump Administration Proposes Rule for Short-Term Health Plans

Under a proposed rule by the Trump administration released on Tuesday, insurers will again be able to sell short-term health insurance good for up to 12 months. This rule would allow short-term plans to add more choices to the market at a lower cost and could offer broader provider networks than ACA plans in rural areas.

Health and Human Services Secretary Alex Azar said, “We want to open up affordable alternatives to unaffordable Affordable Care Act policies.”

Here are some talking points regarding the rule:

  • 60 days to comment on the proposed rule before changes are made to the current rules
  • If approved, insurers may be able to sell short-term health insurance for up to 12 months
  • Comments also being sought to extend beyond 12 months and if there are ways to guarantee renewability of the plans
  • No changes to requirements for STM plans – subject to pre-ex and not held to ACA requirements/not ACA compliant, med questionnaire required, etc.

 

RESOURCES

Trump Administration Proposes Rule to Loosen Curbs on Short-Term Health Plans

Fact Sheet: Short-Term, Limited-Duration Insurance Proposed Rule

Click here to review the proposed rule

Proposed rule would loosen restrictions on short-term health plans

Narrowing Medicare “Doughnut Hole” Will Close In 2019

For Medicare Part D beneficiaries with high prescription drug expenses, the “Doughnut Hole” means they pay more for their medicine once costs reach a certain threshold. Narrowing each year since the Affordable Care Act was passed in 2010, the gap was scheduled to close in 2020. With the 2/16 budget deal, the doughnut hole will now close in 2019.

Read the full story here.