Facts about the 2020 Federal Health Insurance Rules

 

Tablo reader up chevron

#1

The centers for medicare and Medicaid services has just finished setting the rules and numbers health insurers need to design the individual commercial major medical insurance policies for 2020. 

There are many changes that could affect agents, brokers and web brokers. Underneath is the summary of the changes that were done to the “benefit and  payment parameters” in order  to help you prepare for health insurance 2020:

  1. 2020 Parameters basics 

One of the ACA programs that CMS managers are healthcare.gove. It runs a web-based health insurance website that markets for 38 states. The website sells coverage from private insurers as well. Twelve states and the district of Columbia run ACA exchange programs for their residents. The final 2020 parameter documents are much shorter than the 2019 parameters document. This might be taken as a sign that overall any changes in ACA commercial health insurance program rules will have a smaller effect in 2020 than the previous years. 

  1. Web broker enforcement changes 

CMS has put new parameters document that affect how the healthcare.gov web brokers display health plan database search results, and how it will punish producers and web broker entities that broke the rules. 

The brokers are now not allowed to be base search results based on plan compensation levels. This means, that the customer will be able to gauge the real benefit and quality of the search result instead of having to see a certain insurer to be displayed on the top of the list because of that agency pays the broker commission. 

If a broker is found not abiding this rule, then CMS will terminate that agent and broker immediately. 

  1. Special enrollment periods

The ACA individual major medical “open enrollment system” limits, when people can buy health coverage without showing they have the government, classifies as a good reason to be shopping for insurance. The purpose is to protect health insurers' ability to offer major medical insurance without medical underwriting, by encouraging healthy people to stay insured all the time, while they are feeling healthy. 

  1. Cost-sharing and affordability limits 

There are a couple of changes that the government is bringing to the cost-sharing and affordability limits parameters. They plan to increase the limit of the self only affordability cut off for an employee plan coverage to 8,24%. The officials are also increasing the amount of annual cost-sharing amount to $8,150 for self only coverage and $16,000 for family coverage. 

Takeaway: 

There are many policy changes that the government is planning to bring on the table to improve the quality of the health coverage that the citizens are receiving. It also hopes to improve the number of people that can be covered by the insurance policy, and people who are eligible for it without burdening them with a high amount of premium which they can not afford. 

Comment Log in or Join Tablo to comment on this chapter...
~

You might like usman's other books...