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2016 Benefit and Payment Parameters Proposed Rule: Reinsurance, Risk Adjustment, and Risk Corridor Programs; Health Insurance Rate Review; and the Individual and SHOP Exchanges
Health Affairs
[Guidance Overview] Nov. 23, 2014 "Several methods are available to contributing entities for counting enrollees two of which -- the snapshot count and snapshot factor methods -- are explained in greater depth in the proposed rule ... The proposed rule also explains how contributing entities can prorate contributions if they cover enrollees for only part of the year.... The proposed rule extends to 2015 a safe harbor for non-compliance with the risk adjustment and reinsurance data requirements, recognizing the complexity of the requirements.... [The] rule proposes a number of changes in the ACA rate review program.... The proposed rule makes a number of changes in the rules governing exchanges (which are once again referred to as exchanges rather than marketplaces).... [HHS] is considering changing the default rule so that enrollees who do not affirmatively change plans would be auto-reenrolled into a low-cost plan (perhaps randomly) in the same metal level if the cost of the enrollee's plan increased, or increased more than a threshold amount (5 or 10 percent).... Proposed amendments to the SHOP rule would allow exchanges to assist an employer in administering continuation coverage by collecting premiums for such coverage directly from former employees." MORE >> |
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