May 12 – May 18, 2015

Note: From May 19, 2015, through September 8, 2015, we will be posting on a biweekly basis.

Clarification on Requirements for Preventive Care Without Cost-Sharing: On May 11, the Departments of Labor, Health and Human Services, and the Treasury issued a Frequently Asked Questions document to clarify the preventive health care services that insurers are required to cover without cost-sharing under the Affordable Care Act. The document addresses coverage for specific types of breast cancer screening, contraceptives, health care for transgender individuals, preventive services for dependents, and anesthesia for preventive colonoscopies.

State-Based Marketplace Updates:

  • Colorado: To help put the marketplace on a surer financial footing, the Connect for Health Colorado board of directors announced it would collect 3.5 percent of premiums for each 2016 qualified health plan sold on the marketplace (up from 1.4 percent in 2015). This 3.5 percent assessment is in line with the federal marketplace; other state-based marketplaces have a variety of revenue structures. The board also voted to increase 2016 fees on all individual market plans from $1.25 to $1.80 per policy/per month.
  • Massachusetts: Because of a technical issue that prevented the Massachusetts Health Connector from verifying eligibility online, everyone enrolled in MassHealth, the state’s Medicaid program, will need to re-apply for coverage this year to stay covered. Half of the program’s enrollees were notified in January and given an April 17 deadline to re-apply; the other half will receive notices in July with information on their deadline. Consumers who missed the April 17 deadline and had their coverage cancelled can re-apply until June 30 on the Connector website or by phone at 800-841-2900 for retroactive coverage.
  • Minnesota: MNsure is working to fix a data transfer glitch that caused incomplete determinations during the auto-renewal process this year for 55,000 Minnesotans in Medicaid and MinnesotaCare. Once the glitch is fixed, MNsure will re-run the eligibility determinations and notify enrollees who need to submit additional information to demonstrate their eligibility for Medicaid/MinnesotaCare. No consumers are at risk of losing coverage right now, but some may have to find other coverage options if they are ultimately determined ineligible for Medicaid/MinnesotaCare.
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