State Exchanges Provided Flexibility in Using Establishment Funds

CMS released new guidance outlining the allowable uses of federal grant funds for Marketplace establishment. State-based Marketplaces must be self-sustaining as of January 1, 2015 and may not use federal grant funds for ongoing operations. However, the guidance advises current Marketplaces grantees of establishment activities eligible for federal support: stabilizing Marketplace IT systems, instituting financial and program audit procedures, supporting outreach and education, providing manual support for call centers if IT functionality is under development, and planning for long-term capital support of the Marketplace. The guidance also allows Marketplaces to request extensions on establishment grant funds at no cost to complete activities.

HealthCare.gov Seeks Comment on Cost Comparison Tool

CMS announced the development of an Out-of-Pocket (OOP) comparison tool for the 2016 annual open enrollment period. The OOP tool will allow consumers in HealthCare.gov to estimate total spending, including both premium and expected medical costs. CMS is requesting public comment on the development of the OOP tool including the methodology for incorporating cost data, cost-sharing data, and user input on consumer demographics. CMS is also proposing to make the tool’s source code available to State-based Marketplaces. The deadline for public comment is June 29, 2015.

CMS Updates Requirements on Plan Information for Consumers

CMS finalized a rule updating requirements for information plans must provide to consumers. The final rule clarifies that insurers must make coverage information accessible online to all interested consumers. The rule also lays out revisions for the Summary of Benefits and Coverage(SBC) including the content and the form and manner in which the SBC must be provided.