Why am I getting a “1411 Certification?”
- Friday, 08 July 2016 09:49
From Labor Attorney Jason Cogdill:
I have received many reports about employers receiving notices from the Marketplace since the middle of last week. These are “1411 Certifications” from HHS identifying individuals currently receiving an advanced premium credit (or cost-sharing reduction) and whose application referenced a specific employer. It is likely that the majority of employers will receive at least one of these notices, so if your clients have not communicated to you about the notices, they soon will.
Read more ...
Connecticut CO-OP fails…
- Thursday, 07 July 2016 16:06
Connecticut Co-Op Healthy CT will stop selling plans and wind down enrollment over the next 12 months. 40,000 people will lose their coverage under ObamaCare, for the same reasons as all the others- ObamaCare is underfunded, although for slightly different reasons this time. They will no longer be able to renew coverage as of August 1.
This makes it the 14th of the 23 CO-OPs formed by ObamaCare to fail (61%)
Read more ...
SC ObamaCare Exchanges to “implode”?
- Sunday, 03 July 2016 09:45
This is from the Post Courier on July 2. For the full article, click here.
COLUMBIA — With insurers struggling to make money and access to plans severely limited, top South Carolina health officials warn the Obamacare health insurance marketplace is on the verge of collapse.
Obamacare was supposed to create a competitive platform for customers to shop for coverage. But in most South Carolina counties, HealthCare.gov more closely resembles a monopoly dominated by the largest private health insurance company in the state — BlueCross BlueShield.
Next year, access to Obamacare in South Carolina will likely become even more limited. United Healthcare, which sells Affordable Care Act plans in five counties and in several other states, has announced it will leave most markets in 2017. The company estimates it lost $475 million on Obamacare customers across the country last year.
Oxford pulling HMO and POS from NY Market
- Sunday, 26 June 2016 07:45
Beginning with January renewals, Oxford will no longer make the Oxford HMO and POS plans available. the PPO and EPO plans will continue to be available. This impacts a lot of groups, as the LIberty HMO was the “affordable” alternative for a company that wanted to keep Oxford.
The company also has indicated it is leaving the individual off-exchange market in NY as well.
Oxford Health Plans (NY), Inc. (OHP) License Withdrawal,
Effective January 1, 2017, Upon Renewal
We have conducted a review of our entire portfolio, which has led us to the decision to exit the commercial market on our Oxford Health Plans (NY), Inc. (OHP) license in 2017. This change will result in withdrawal of our individual and small group OHP New York HMO products and our large group OHP New York POS product. This change will occur on your clients’ 2017 renewal date, beginning January 1, 2017. Please work with your affected clients to ensure they have selected a new OHI group plan before their current coverage ends.
This change does not affect our Oxford Health Insurance, Inc. (OHI) plans. Our OHI portfolio in New York offers a wide range of coverage options for employers of all sizes.
Impacted groups and members will receive a notice from us approximately 180-days prior to their 2017 coverage end date. The notice will outline the actions they need to take and other available coverage options. Samples of the 180-day communications are enclosed. The first mail drop to January 2017 renewing groups, their members, and individual policy holders will be postmarked by July 1, 2016, with subsequent mailings issued monthly thereafter to renewing groups and their members through June 2017.
What this means for your clients
- Large group employers will need to select a new OHI plan for their affected members. This change will not impact most of your customers since only a small number of large group customers continue to offer this product. If your client is impacted by this change, our representatives will reach out to you. Representatives are prepared to work with you and your clients to help simplify this transition and minimize disruption to affected members.
- Small group employers offering both OHP and OHI plans – We will automatically move the OHP HMO members into a similar OHI plan, upon the group’s scheduled renewal date. We have enclosed information on the specific OHP plans that are being withdrawn from the market, as well as replacement OHI options for your reference. This change will not affect the group’s existing OHI plan(s). If necessary, we will add a new OHI plan to the group’s current offerings to support the population being transitioned. Information about any new OHI plan will be included in the group’s renewal package and accessible through our Oxford small group online enrollment tool, Idea Management SystemSM (IDEA). If your clients would prefer to add a different plan, please work with your clients to ensure they have selected a new OHI plan before their OHI renewal date.
- Small group employers offering only an OHP plan – These employers will need to take action to purchase a new policy before the end date of their current OHP plan. Since their current OHP plan is not renewing, the groups will not receive a renewal package from us. These groups will need to apply as a new group. For your convenience, information about a similar replacement option will be viewable in IDEA, where you can enroll groups in new coverage and upload supporting required documentation, such as tax documents and waivers. If you are not able to access IDEA, you can also send us a paper application.
- Healthy NY groups will be offered similar coverage from our affiliate, Oxford Health Insurance (OHI). These groups will not have to complete a new application for coverage. We will ask them only for the Healthy NY Recertification Form, which is a standard part of the annual renewal process.
Groups that continue to meet Healthy NY requirements and submit the Form will be automatically moved into the new Healthy NY OHI plan, upon the group’s scheduled renewal date. Groups that do not complete the Form, no longer meet Healthy NY requirements or would like to choose a different plan can re-apply for Oxford small group coverage in an OHI plan.
- Oxford Individual plan members will need to take action and must enroll in a new plan to have health insurance in 2017. The last day of coverage for these members, under their current plan, is December 31, 2016. We encourage you to work with your affected clients to seek replacement coverage through the New York State of Health, the Official Health Plan Marketplace (“the Marketplace”). The Marketplace offers a variety of coverage options from a number of insurers and premium assistance is available for those who qualify.