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AHIP Wants Consumers to Know What They're Really Buying

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America’s Health Insurance Plans (AHIP) wants everyone to understand that major medical insurance is different from limited-benefit health insurance, short-term medical insurance, and other arrangements often suggested as alternatives.

Cathryn Donaldson, AHIP’s director of communications, talked about the group’s views on the purported alternatives during a recent interview in New York.

“We welcome [companies] selling those products,” Donaldson said.

(Related: Should Say How It’s Using Insurers’ Cash: AHIP)

Short-term medical insurance, for example, can be valuable to people who need something to fill in gaps in major medical coverage, she said.

But Donaldson said AHIP wants to make sure issuers and agents do a good job of telling consumers what products do and don’t do.

“We want people to make sure they know what they are,” Donaldson said.

Disclosure rules are especially important for health benefits products that are not actually insurance, Donaldson said.

She cited health care cost-sharing ministries, and any new plans set up under the Trump administration’s new association health plan regulations, as examples of arrangements that, under federal rules, do not have to follow the same kinds of underwriting and financial stability rules that an insured plan would have to follow.

AHIP is not talking much these days, however, about an issue that seemed like a major concern a year ago: a shorter individual major medical insurance open enrollment period.

Open Enrollment Period Changes

An “open enrollment period” system is a system that puts limits on when people have an easy time buying health insurance.

The idea is to scare healthy people into signing up for coverage during the open enrollment period, and paying for coverage year-round, because of a fear that, otherwise, they could suddenly end up with serious health problems outside the open enrollment period, and no way to get health coverage until the start of the next open enrollment period.

Regulators, insurers and Affordable Care Act public exchange managers set up an open enrollment period system for the individual major medical market to compensate for ACA rules that eliminated many of insurers’ old defenses against medical claim risk, such as refusing to cover people with serious health problems.

The ACA individual market rules began to apply for coverage that took effect on or after Jan. 1, 2014.

For 2014, the administration of former President Barack Obama scheduled the open enrollment period to start Oct. 1, 2013, and end March 31, 2014.

Later, open enrollment periods ran from Nov.1 through Jan. 31.

For 2018, the Trump administration used an open enrollment period that from Nov. 1 through Dec. 15.

The administration is planning to stick with a Nov. 1 start date and a Dec. 15 end date for the 2019 open enrollment period.

When the 2018 open enrollment period started, many insurers hoped having a shorter enrollment period would put pressure on healthy consumers to sign up for health coverage promptly, by increasing the odds that consumers who procrastinated would end up getting serious health problems during the off season.tes worried that a shorter open enrollment period would simply hurt enrollment.

In the end, consumers seemed to cope with the shorter open enrollment period reasonably well: enrollment was only 5% lower for 2018 than it was for 2017, in spite of the shorter enrollment period and a 90% cut in promotional spending.

So, how did so many consumers know to sign up for coverage by Dec. 15?

“I think there was a lot of work done by our members to make sure people understood that,” Donald said.

This year, the open enrollment period scheduling does not seem to be a member area of focus, Donaldson said.

AHIP does see evidence that officials at the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services are listening to AHIP members’ concerns.

Alex Azar, the HHS secretary,  spoke at an AHIP board meeting, Donaldson said.

— Read Matt Eyles to Succeed Marilyn Tavenner As AHIP Presidenton ThinkAdvisor.

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© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.