On May 16, the Exchange and Insurance Market Standards for 2015 and Beyond, another 436 pages of rules, regulations and interpretations was released.
Perhaps the biggest change that will affect our clients is that the “Certificate of Creditable Coverage,” AKA the HIPAA certificate, will no longer be required at the end of this year. All plans are supposed to be covering pre-existing conditions by then, and at the end of this years open enrollment (12/7/14) individuals that do not purchase coverage will not be eligible during the year, so they won’t be needed.
The effective dates of coverage and terms of special enrollment periods for a variety of circumstances, including births or adoptions, marriage, insurer breach of contract, exceptional circumstances or misconduct by a non-exchange entity providing enrollment assistance and general loss of minimum essential coverage have been clarified.
Next year, you can get an individual mandate hardship exemption if your cost to buy coverage would exceed 8.05% of your income.
Individual and small group market consumers and their physicians have a new emergency procedure to use to request coverage by an insurer of non-formulary drugs.