On September 5, 2014, the Centers for Medicare and Medicaid Services (CMS) published a final rule, effective October 6, 2014, that, among other things, specifies the auto-enrollment process for consumers who receive health insurance coverage through a qualified health plan offered under a federally-facilitated marketplace (Marketplace). According to a fact sheet released by CMS, “[a]s part of the renewal process in the [Marketplace], generally, if consumers do nothing, they will be auto-enrolled in the same plan with the same premium tax credit and other financial assistance, if applicable, as the 2014 plan year.” According to the CMS Administrator, Marilyn Tavenner, this streamlined process is available to those “consumers who are happy with their plan and have no changes to their income or family situation.”

However, CMS encourages consumers to return to the Marketplace to make sure they are getting all the financial assistance they qualify for, and to shop for the plan that best suits their needs. Additionally, CMS cautions that “[c]onsumers whose 2013 tax return indicates that they had very high income, or who did not give the Marketplace permission to check updated tax return information for annual eligibility redetermination purposes will get auto-enrolled without financial assistance if they do not return to HealthCare.gov.”

Marketplace consumers will receive notices shortly before open enrollment begins explaining the auto-enrollment process in additional detail.






Posted by Jennifer K. Shanley

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