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Recent Developments: New ACA Guidance, Church Plans and Contraceptive Coverage
Timothy Jost, in Health Affairs Forefront Link to more items from this source
[Guidance Overview]
Jan. 13, 2014

"[FAQ 18 clarifies] again that plans and insurers are not required to count out-of-pocket spending for out-of-network providers towards the out-of-pocket maximum, although they may do so. However, HHS strongly urges qualified health plans to allow in-network coverage for providers listed in the QHP's provider directory for early months of coverage if the provider directory was not current and an individual signs up for a QHP only to find that his or her provider is not in-network. Plans are also not required to count toward the out-of-pocket maximum expenditures for non-covered services, although they may do so."

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