March 24 – March 30, 2015

New Fact Sheets for Consumers on the Fine for Not Having Health Coverage in 2014: On March 27, the Department of the Treasury posted five new fact sheets for consumers explaining situations where individuals are not be required to have health insurance — consumers in the Medicaid gap, for instance — and how to get an exemption from the fine for not having health coverage in 2014 if eligible.

Funding Opportunity Announced for Helping Historically Uninsured Communities Get Covered: On March 19, the Department of Health and Human Services (HHS) announced a new funding opportunity for the Partnerships to Increase Coverage in Communities II (PICC II) Initiative. Organizations can use PICC II Initiative grant awards to conduct outreach and education and provide enrollment assistance to communities that historically have been more likely to be uninsured, including racial/ethnic minorities and those that are economically and environmentally disadvantaged. Applications are due May 22 and open to organizations in all 50 states and the District of Columbia. HHS estimates they will award $3.5 million in grants for the third open enrollment period (OE3). For OE2, HHS awarded $3.2 million in PICC Initiative awards to 13 organizations in September 2014.

Application Open for Organizations Train Agents and Brokers on Marketplace Enrollment: Organizations that are interested in being able to certify agents and brokers for federally facilitated marketplace (FFM) enrollment can now apply to be official vendors. Applications are due April 7.

State-Based Marketplace (SBM) Updates:

  • California: Covered California announced that it would send the remaining tens of thousands of updated 1095-A tax forms to consumers by the end of March. The marketplace already sent 120,000 corrected marketplace tax forms to consumers who received tax credits. Treasury and HHS have clarified that no consumer will be required to re-file or make repayments if they filed taxes based on incorrect information from the FFM or an SBM, and this Covered California FAQ covers many questions about the1095-A forms and other tax filing issues.
  • Maryland: An audit by the HHS Office of Inspector General found that Maryland had misallocated $28.4 million in federal funding to set up its SBM (Maryland Health Connection). In response, the state issued a statement and Q&A document stating that Maryland Health Connection allocated correct proportions of funding from two federal sources.
  • New York: A New York state law went into effect March 31 that provides new consumer protections, including limiting out-of-pocket costs for consumers who unintentionally receive out-of-network care and requiring greater transparency in provider networks. The protections apply prospectively to consumers who enroll in or renew in a plan starting April 1. Consumer guidance from the state Department of Financial Services is available here.
  • Washington State: On March 26, the Washington Healthplanfinder released a report on marketplace and Medicaid enrollment as of March 9, including demographic, county-by-county, and issuer-specific breakdowns. More than 165,000 consumers were enrolled in marketplace coverage, including 67,000 new enrollees from OE2, and 530,000 adults were newly covered by Medicaid.
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