Recent CMS subregulatory guidance and related announcements regarding ACA insurance coverage and insurance exchange issues include the following:

  • On March 14, 2014, CMS released its final “2015 Letter to Issuers in the Federally-facilitated Marketplaces,” which provides operational and technical guidance to issuers seeking to offer qualified health plans (QHPs) in a federally-facilitated Marketplace and/or SHOP.
  • CMS is extending its previously-announced “hardship” exemption and allowing consumers in the individual and small group markets to renew policies that do not comply with ACA QHP standards through October 1, 2016 (if the policies are still offered and if permitted by applicable state authorities). CMS will consider the impact of this two-year extension of the “transitional policy” in assessing whether an additional one-year extension is appropriate. 
  • An HHS blog post announced that beginning in 2015, if an insurance company offers health coverage to opposite-sex spouses, it cannot choose to deny that coverage to same-sex spouses.
  • CMS is allowing enrollees in the federal Pre-Existing Condition Insurance Plan (PCIP) who have not yet enrolled in new health insurance coverage through an Exchange plan to purchase an additional month of PCIP coverage, through April 30, 2014.