Stakeholders received two holiday gifts from the Obama administration late on Friday, December 19, 2014, with the release of two proposed documents affecting health insurance issuers’ offering of private health insurance products both inside and outside of the Public Insurance Exchanges.
The Centers for Medicare & Medicaid Services (“CMS”) released its Draft 2016 Letter to Issuers in the Federally-facilitated Marketplaces (“Draft Letter”) more than a month earlier than the time frame under which CMS released its 2015 version of this document. While the Draft Letter largely mirrors the provisions of the 2015 Letter to Issuers in the Federally-facilitated Marketplaces, or restates proposals from the proposed 2016 Notice of Benefit and Payment Parameters, CMS does propose several significant changes for the 2016 application cycle. These include the use of an earlier timeline for application submission, review, and approval, as well as a more extensive review of benefit offerings for compliance with non-discrimination requirements.
That same day, the Departments of Health and Human Services, Labor and Treasury (collectively, “Departments”) released a proposed amendment to expand federal regulations on excepted benefits to except from specific Affordable Care Act requirements certain wraparound coverage offered by group health plans (“Proposed Rule”).
Depending on the specific topic, the Draft Letter and Proposed Rule will impact the individual, small group, and/or large group markets. CMS is accepting comments on the Draft Letter through January 12, 2015. The Departments are accepting comments on the Proposed Rule through January 22, 2015.