CMS Announces HIX Changes for 2015

Christopher Cheney, March 20, 2014

New 2015 rules for the health insurance exchanges establish a clear and relatively straightforward path to renewing health plans and beneficiary policies. But several payer concerns still remain.

In their "Final 2015 Letter" released Friday for the new public exchanges, federal officials announce a relatively easy framework for health plan and beneficiary policy renewals for 2015, adopt changes related to provider networks, and set a 2015 health plan application timeline that pegs open enrollment to begin Nov. 15.

Health plan executives and state exchange officials alike have anxiously awaited a decision on how the federal Centers for Medicare and Medicaid Services would set 2015 renewal rules. The prospect of requiring all beneficiaries to obtain 2015 coverage through open enrollment had prompted fears of beneficiaries dropping out of the exchanges or switching health plans in large numbers, disrupting the nascent markets for individual and small business health insurance.

In the Final 2015 Letter, CMS states, "Current enrollees in recertified plans will remain enrolled into the new benefit year, as long as those enrollees do not terminate their coverage."

The new rules released Friday also allow insurers operating on the exchanges to keep 2014 carrier and health plan identification numbers for plans recertified for 2015. The insurers' trade association, America's Health Insurance Plans, had predicted a logistical nightmare if new identification numbers were required in 2015. "Changing these IDs would be extremely disruptive both for consumers (in not having the option to remain enrolled in their current QHP) as well as for plans in supporting the electronic file transfer between the Exchange and the plan," AHIP officials said in formal comments submitted to CMS on Feb. 25.

Christopher Cheney

Christopher Cheney is the senior finance editor at HealthLeaders Media.


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