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Text of CMS Final Master FAQs on Health Insurance Market Reforms and Marketplace Standards (PDF)
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]
[Official Guidance] May 18, 2014
7 pages (May 16, 2014); 12 Q&As, including: "[1] For plans that must provide coverage of the essential health benefit package ... if an issuer imposes a waiting period before an enrollee can access a covered benefit, is that a violation of 45 CFR 156.125? ... We are concerned that waiting periods for specific benefits discourage enrollment of or discriminate against individuals with significant health needs or present or predicted disability.... [2] Are conversion policies offered to individuals losing group health insurance coverage considered to be minimum essential coverage ...? Yes ... [3] Would a large employer with 51-100 employees who is a large group policyholder be covered by the March 5, 2014 bulletin with respect to a renewal of its 2013 plan at its 2014 renewal date if the policy is not compliant with the provisions of the ACA that apply to the large group market? No.... [4] Is a large group employer who employs 51-100 employees required to remain with the same insurer between 2013 and 2016 in order to be eligible for transitional relief in 2016? No.... [5] If an individual or small employer purchased a 2014 ACA-compliant plan, are there circumstances where the policyholder can have the 2013 plan reinstated and be eligible for the transitional policy relief? No.... [6] Does the large employer transitional policy starting in 2016 apply to large employers with 51-100 employees who did not have health insurance coverage at the time the transitional policy extension bulletin was issued March 5, 2014, but who purchase a large employer policy after March 5, 2014 but before January 1, 2016? Yes."
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