With some carriers in some areas deciding to discontinue their “on exchange” plans and leave the Health Insurance Marketplace for 2017, the Centers for Medicare and Medicaid Services (CMS) has announced it will automatically re-enroll individuals of these discontinued plans into similar plans offered by carriers still selling in the marketplace. Starting with plan year 2017, this auto-enrollment will apply in all states using the federally-facilitated marketplace (FFM), as well as to state-based exchanges operating on the federal platform. Their intent is to make sure members do not have a lapse in coverage.
How members will be notified
During the first weeks of November, CMS will send letters to members of these discontinued plans letting them know that their insurer has left the exchange. A follow-up letter will match them to an alternate plan offered by a different carrier. In choosing a different plan for auto re-enrollment, CMS will attempt to select one in the same metal level and same or similar product and network type. The CMS letter may show the new plan premium and any applicable subsidy details. Also, if the member logs into healthcare.gov, he or she will see this message: “If your current plan isn’t available for 2017, an alternate plan is displayed for you to consider.”
After CMS lets us know which individuals they automatically enrolled in one of our plans, we will welcome these members with a letter and let them know how to activate their coverage. Of course, they are under no obligation to stay in the plan CMS selected. They are free to shop for other plans during open enrollment.
How brokers will be notified
In late November, CMS will send us an enrollment file of auto-enrolled members. We expect this file will include any applicable broker information. Any members automatically enrolled with us who are also your clients will show on your submitted Applications Dashboard in Producer Toolbox as “Missing Initial Payment.”
We will treat these individuals as new enrollees, so with respect to commissions, brokers currently appointed with us will receive the first-year, new business commission for these members, based on our commission schedule for 2017. We will not pay commissions to brokers not appointed with us.
Like any new member, these individuals need to make their premium payment by January 1, 2017, or within 30 days of our receipt of their application, whichever is later, for their coverage to be effective on January 1, 2017. Of course, they may select a different plan up until January 31, 2017, the end of open enrollment, but members who do not make a decision and pay by January 1 risk not having coverage effective January 1. Also, members will not receive their ID cards until they have paid their first month's premium.