Dive Brief:
- CMS has finalized a new rule allowing existing marketplace consumers to auto-enroll for 2015. Enrollees who don't return to Healthcare.gov to shop for a new plan will be auto-enrolled in the same plan next year.
- Consumers will receive notification from the Marketplace before open enrollment begins, explaining the auto-enrollment process and encouraging them to shop for plans and make sure they are getting the financial assistance for which they are eligible. If consumers do nothing, however, they will be automatically re-enrolled in the same plan as their 2014 coverage, with the same premium tax credit and other financial assistance, if applicable.
- If a consumer's 2013 tax return indicates a high income or the consumer did not give the Marketplace permission to check updated tax information to determine eligibility for financial assistance, the consumer will be auto-enrolled without financial assistance.
Dive Insight:
Insurance companies will also provide advance notice to consumers about their new 2015 premiums and the amount they may save on their monthly bills with a premium tax credit.
The new guidelines will bring the exchanges in line with the current insurance marketplace, in which the majority of consumers are typically auto-enrolled in their plans each year. For example, about 88% of employees who receive coverage via the Federal Employee Health Benefits Program are auto-enrolled each year, with updated premiums and benefits.
The rule will be published in the Federal Register September 5 and will be effective 30 days from that date.