CCIIO gives small group non-grandfathered policies more time to ease into ACA compliance

The Center for Consumer Information & Insurance Oversight (CCIIO) has issued guidance stating that it is extending its transitional policy allowing certain health policies to continue coverage that would otherwise be cancelled for noncompliance with various provisions of the Public Health Service Act and Sec. 1312(c) of the Patient Protection and Affordable Care Act (ACA). The extension of the transition is available to non-grandfathered policies in the small group and individual market.

When originally outlining the policy, the Centers for Medicare & Medicaid Services (CMS) advised that, if permitted by applicable state authorities, health insurance issuers could continue such coverage, and small businesses and individuals could re-enroll in the coverage, if the policies were renewed for a policy year starting between January 1, 2014 and October 1, 2014. On March 5, 2014, the CMS extended to transitional policy to policy years beginning on or before October 1, 2016, and, on February 29, 2016, the CMS extended it again, for policy years beginning on or before October 1, 2017, provided that all policies end by December 31, 2017.

Extension to 2018. Now, according to the latest CCIIO guidance, states may permit issuers that have already renewed policies under the transitional policy continually since 2014 to renew that coverage for policy years starting on or before October 1, 2018, as long as they do not extend coverage beyond December 31, 2018. The CCIIO says that it will work with issuers and states on implementation of the transitional policy on options that include allowing policy years that are shorter, but not longer, than 12 months, or early renewals with a January 1, 2018 start date.

The CCIIO believes that this extension will facilitate smooth transitions from transitional coverage to ACA-compliant coverage, which requires a calendar year policy year in the individual market. States will be allowed to adopt the extended transitional policy for either the individual market alone, the small group market alone, or both the individual and small group markets.

Questions about the new guidance can be directed to

SOURCE: Extended transition to Affordable Care Act – Compliant Policies, February 23, 2017.

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