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August 04, 2014 at 12:57 PM
The public exchanges run by the U.S. Department of Health and Human Services (HHS) will be forgiving to consumers who fail to pay their 2014 exchange plan premiums.
When a consumer fails to pay the premiums for qualified health plan (QHP) coverage purchased through an HHS public exchange, the issuer is supposed to cancel the coverage. When, however, the 2015 open enrollment period rolls around, the consumer can apply for coverage from any available QHP — including the QHP that the consumer stiffed this year.
See also: Hospitals, insurers at odds over premium payments
When the consumer starts paying for the 2015 QHP coverage, the issuer cannot use any of the consumer’s new payments toward paying off the outstanding debt from the old, terminated, 2014 coverage, according to officials at the Centers for Medicare & Medicaid Services (CMS).
CMS — an arm of HHS — gives the rules that apply to consumers who have failed to make timely payments for QHP coverage in a new batch of advice aimed at agents, brokers and other exchange helpers. The information sheet applies directly to exchanges established or managed by HHS. It could have an indirect effect on the rules managers of state-based exchanges adopt.
