Exchanges get broad retroactive cover power

Managers of a state-based public exchange may be able to wait until the fall — as long as the day before the start of the 2015 open enrollment period — to provide retroactive coverage for glitch victims.

Officials at the Center for Consumer Information & Insurance Office, an arm of the Centers for Medicare & Medicaid Services, gave that update in one of several new documents they released today.

CCIIO — the federal office responsible for overseeing most U.S. Department of Health and Human Services efforts to implement the Patient Protection and Affordable Care Act — told exchange managers in February that state-based exchanges could deal with enrollment system problems by offering consumers access to retroactive coverage, along with access to the new PPACA premium tax credits.

The federal exchanges run by HHS can use the retroactive coverage guidance, too, if they want, but HHS already has another enrollment process in place for consumers affected by “exceptional” enrollment problem circumstances, officials say in a bulletin addressed to exchange managers.

In the same batch of guidance, CCIIO officials said state-based exchanges facing technical problems can follow the lead of CCIIO and let employers enroll in Small Business Health Options Program exchange programs directly with the insurers, rather than making the employers try to enroll in SHOP plans through a broken website.