December 23, 2014 – January 5, 2015

2015 Marketplace Health Coverage Begins: On January 1, coverage began for consumers who enrolled by the December 15 deadline. On the federally facilitated marketplace (FFM) and many state-based marketplaces (SBMs), most 2014 enrollees who did not take action were automatically re-enrolled into 2015 coverage. Consumers experiencing issues with auto re-enrollment may qualify for Special Enrollment Periods (SEPs) to sign up for coverage with a coverage effective date of January 1. All consumers can still apply through the marketplaces until February 15 online, by phone (1-800-318-2596), by paper application, or with in-person assistance.

Expanded Medicaid Coverage Begins in Pennsylvania: On January 1, coverage for Pennsylvania residents with incomes up to 138 percent of the federal poverty level began under the state’s expanded Medicaid program, Healthy Pennsylvania. Since enrollment began on December 1, the commonwealth has received more than 100,000 applications. Eligible Pennsylvanians can enroll online, in person, or over the phone (866-550-4355).

Enrollment Report: Millions Enroll in Time for January 1 Marketplace Coverage: On December 30, the Department of Health and Human Services (HHS) released its first monthly enrollment report for the second open enrollment period (OE2). From November 15 through December 15, 3.4 million people enrolled in the 37 states using HealthCare.gov. Eighty-seven percent of FFM enrollees qualified for financial help. In addition, in the first month of OE2, 600,000 consumers enrolled in coverage through state-based marketplaces. While the FFM total does not include automatic re-enrollments, five state-based marketplaces did include them in their enrollments counts. In comparison, 2.2 million consumers enrolled for January 1 coverage in 2014.

Proposed Changes to Summary of Benefits and Coverage: On December 22, the Departments of Health and Human Services, Labor, and Treasury issued a proposed rule amending the Summary of Benefits and Coverage (SBC), the uniform explanation of benefits that insurers are required to provide for each product they offer. The amended SBC template is two pages shorter than the current iteration and includes additional illustrative examples of costs when consumers use their health plans as well as an updated glossary of terms; the changes are based on consumer testing. Comments on the proposed rule are due March 2.

HHS Updates:

  • New HealthCare.gov Resource on Filing Taxes: A new section of HealthCare.gov gives consumers tips on how health coverage affects their 2014 federal income tax return, including the new Form 1095-A.
  • Tip on Removing 2014 Dependents from 2015 Applications: People who enrolled on HealthCare.gov in 2014, are updating their information for 2015, and are having difficulty removing a dependent from their application should contact the HealthCare.gov call center at 1-800-318-2596 to resolve the issue.

OE2 Enrollment Updates:

  • FFM: A total of 6,490,492 Americans were enrolled in plans through HealthCare.gov, including automatic re-enrollments, as of December 26.
  • District of Columbia: A total of 18,773 marketplace plan selections and 37,457 Medicaid/CHIP enrollments as of December 21.
  • Maryland: A total of 86,347 marketplace plan selections and 67,255 Medicaid/CHIP enrollments total as of January 1.
  • Massachusetts: A total 73,369 marketplace plan selections and 148,932 Medicaid/CHIP enrollments as of January 4.
  • Minnesota: A total of 31,159 marketplace plan selections and 37,692 Medicaid/CHIP enrollments as of December 31.
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