A health insurer that wants to change its major medical product menu in 2015 will have to think hard about where the enrollees go next.
Jackie Garner, the new acting director at the Center for Consumer Information & Insurance Oversight (CCIIO), talks about the rules governing major medical product menu changes in a bulletin aimed at insurers. The bulletin applies to all major medical products, including the qualified health plans (QHPs) sold through the Patient Protection and Affordable Care Act (PPACA) exchange system, grandfathered plans, and PPACA-compliant plans sold outside the exchange system.
PPACA now requires a health insurer to guarantee the renewability of any individual or group major medical product, Garner writes. An insurer can cancel coverage only if it kills an entire product line in a market or stops selling any coverage in a market. An insurer is supposed to warn individual coverage holders or group plan sponsors 90 calendar days before shutting down a plan.
CCIIO — an arm of the U.S. Department of Health and Human Services (HHS) — manages HHS-run public exchanges in some states, and it manages state-based exchanges in other states. The 2015 PPACA exchange open enrollment period is set to start Nov. 15, 2014, and end Feb. 15, 2015.
Normally, PPACA would require a health insurer that is killing a plan Jan. 1, 2015, to get discontinuation notices to sponsors or enrollees by Oct. 3.