Health policy extension war rages on

Several insurance commissioners in other states came out with their own extension proposal decisions. Idaho and North Dakota will encourage carriers to continue policies; officials in Indiana called the administration’s request for a change in rules “untimely” and denied it.

The Center for Consumer Information & Insurance Oversight—the arm of the Center for Medicare & Medicaid Services in charge of many U.S. Department of Health and Human Services PPACA implementation efforts—posted a model policyholder notice and a set of answers to frequently asked questions for states allowing extensions. A carrier must use the exact notice language approved for its state and send the notice to customers separately from any other plan correspondence.

Linda Rowlings, chief compliance officer at United Benefit Advisors, wrote in a commentary that it looks as if carriers that continue non-PPACA policies still must meet some new PPACA requirements, including a requirement that limits eligibility waiting periods to 90 days, a provision that removes pre-existing condition limits for adults in the group market, and a requirement that health plans satisfy health non-discrimination rules. 

Hans Leida, a Milliman consultant, said he believes the extended plans will not, technically, be “grandfathered.” It looks as if the policies might be subject to PPACA standards that have already started to apply to those policies, such as a requirement that plans cover basic preventive services without imposing out-of-pocket costs on the patients.

See also:

• States to decide which plans are PPACA-compliant
• More states push for policy extensions
• Cancellation rules now a headache for state commissioners