Enrollment Deadline for January 1, 2014, Health Plan Coverage Extended to December 23

HHS issued an interim final rule amending the deadline for individuals to select qualified health plans (QHPs) through any health insurance exchange. The deadline for enrolling for a January 1, 2014, effective date has been changed from December 15, 2013, to December 23.

Background

After the Patient Protection and Affordable Care Act (PPACA) was enacted in 2010, HHS published a final rule entitled Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans; Exchange Standards for Employers (Exchange Establishment Rule) (77 FR 18310). Under the Exchange Establishment Rule, individuals must select a QHP on or before December 15, 2013, in order to obtain coverage starting January 1, 2014. Individuals enrolling during the initial open enrollment period of October 1, 2013, through March 31, 2014, would gain coverage with an effective date based on when the plan is selected.

Interim Final Rule

The interim final rule, to be published in the Federal Register on December 17, 2013, adds clarifying language to the Exchange Establishment Rule stating that, for coverage that is offered outside of an exchange or a Small Business Health Option Program (SHOP), plan selections received on or before December 15, 2013, must have coverage taking effect on January 1, 2014. Plan selections that are received between December 16 and December 31, 2013, must have effective dates of February 1, 2014. These dates correlate with the coverage dates originally set out in the Exchange Establishment Rule.

The interim final rule also amends the Exchange Establishment Rule, changing the deadline for January 1, 2014 effective dates to December 23, 2013, rather than December 15. However, for plan selections made on December 24 or later, the coverage effective dates will follow the schedule originally set out in the Exchange Establishment Rule. State exchanges, SHOPs, Federally-facilitated exchanges, and other issuers may allow earlier enrollment dates than specified in the Exchange Establishment Rule, but not later.

Request for Smooth Transition

HHS urged issuers to make efforts to simplify consumers’ transitions between their previous coverage and QHPs, especially in helping consumers maintain access to providers and prescription drug coverage.

The usual procedure of notice-and-comment rulemaking has been waived for good cause, as it is in the public’s interest to delay coverage effective dates further.