|
1552 |
When can issuers expect the CMS 820 Companion Guide to be published? |
CMS
intends to release the SHOP Chapter of the CMS HIX 820 Companion Guide
soon and it will be posted to REGTAP at that time with ... more |
05/08/2014 |
|
|
1553 |
Will only full payments be sent to Issuers or will partial payments be sent? Is there a payment threshold less than 100%? |
Only
full payments will be sent to Issuers. Partial payments can be
collected by the FF-SHOP until 100% payment is received from t ... more |
05/08/2014 |
|
|
1554 |
How will the FF-SHOP handle paper checks and ensure initial payments are received prior to the coverage effective date? |
The
FF-SHOP must receive the initial binder check by the 26th of the month.
If a payment is not received by this date, a cancellat ... more |
05/08/2014 |
|
|
1556 |
Can
a group receive a tax credit off of the SHOP in 2014 or is a group
required to fill out the SHOP paper application and be cons ... more |
In
order to claim the expanded small business healthcare tax credit in
2014, eligible small groups must submit a paper application ... more |
05/08/2014 |
|
|
1557 |
If
an Issuer contacts the SHOP at the end of a group's grace period, will
the SHOP be able to tell the Issuer whether the gro ... more |
As of November 2014, Issuers may contact the SHOP Call Center to receive the current payment status of FF-SHOP groups. |
05/08/2014 |
|
|
1558 |
What
are the employer reporting requirements for terminations? If someone
leaves employment on the 30th of the month, how long doe ... more |
Terminations
may be reported to the FF-SHOP on any day of the month, and the
termination effective date will be the last day of th ... more |
05/08/2014 |
|
|
1560 |
Issuers understand that the FF-SHOP will not accept credit card payments. Will the FF-SHOP accept prepaid debit cards? |
Debit cards will not be accepted. Only ACH direct debit transfers will be accepted. |
05/08/2014 |
|
|
1561 |
For special enrollment periods in SHOP, does plan selection have to occur within 30 days of the triggering event? |
In
most instances, yes, plan selection must occur within 30 days of the
triggering event. The only exception is loss of Medicaid/C ... more |
05/08/2014 |
|
|
1562 |
Is CMS allowing groups to make retroactive changes? |
With
few exceptions, e.g., birth/adoption/death, effective dates in FF-SHOPs
are always the first of the month, and termination ef ... more |
05/08/2014 |
|
|
1563 |
If
an employer is billed 4/10 and the employer notifies the FF-SHOP of an
employee termination of 3/11 on 4/11, what is the employ ... more |
The termination effective date in this example will be 4/30. |
05/08/2014 |
|
|
1566 |
How
will the FF-SHOP's minimum participation rate work in 2015? Will
employers have to meet the default 70% minimum participa ... more |
CMS
regulations require the FF-SHOP to calculate minimum participation
rates at the level of the SHOP--not at the level of an Issu ... more |
05/08/2014 |
|
|
1568 |
Will the 820 218 be sent from CMS to Issuers or be sent directly to the bank? |
The FF-SHOP will send the 820 218 directly to the bank. The 820 306 will be sent to Issuers. |
05/08/2014 |
|
|
1569 |
How
can Issuers contact the SHOP Call Center to receive payment status for a
group enrolled in FF-SHOP beginning in 2015? Will CMS ... more |
Issuers
may contact the SHOP Call Center today with questions involving the
2014 Direct Enrollment Process. The number is 1-800-70 ... more |
05/08/2014 |
|
|
1570 |
Will the 820 have the exchange assigned group ID? |
The
FF-SHOP does not assign Group IDs. Only Issuers generate Group IDs in
FF-SHOPs. Issuer assigned Group ID is an optional elemen ... more |
05/08/2014 |
|
|
1572 |
Will effectuation guidelines for SHOP be updated in terms of what data is required on the 834 effectuation transaction? |
Yes, CMS will cover Group XML and 834 enrollment transactions and required data elements on future REGTAP calls. |
05/08/2014 |
|
|
1573 |
Are
Issuers required to validate that brokers have signed the FFM privacy
and security agreement in order to sell in FF-SHOP, for ... more |
Issuers
are expected to validate that brokers in FF-SHOPs have a valid state
license and have completed the FFM privacy and securi ... more |
05/08/2014 |
|
|
1574 |
Will the FF-SHOP 820 be pushed to a different location than the Individual 820? |
The
payee group set-up determines the file routing. If the Issuer ID for
both SHOP and the Individual Market is the same, 820 HIX ... more |
05/08/2014 |
|
|
1575 |
The
requirement for a group to start with a zero balance does not make
sense for a January enrollment for an existing SHOP group. ... more |
This
is correct. CMS expects there to be a zero balance as of the 2015 plan
year. Issuers will collect any past-due balances from ... more |
05/08/2014 |
|
|
1576 |
Our
state requires that issuers process claims during the grace period. How
will plans bill for coverage during the FF-SHOP grace ... more |
FF-SHOP
QHP and SADP Issuers will not be invoicing any groups with 2015
coverage effective dates. The FF-SHOP will continue to inv ... more |
05/08/2014 |
|