Reform Alert - News from the Blues' Office of National Health Reform

CMS issues FAQ on ancillary products

April 12, 2013

On April 1, the Centers for Medicare and Medicaid Services issued an FAQ clarifying that products such as stand-alone vision plans and disability or life insurance may not be offered through the Marketplace.

Ancillary insurance products, which are not qualified health plans (QHPs), may be offered by separate state programs that share resources and infrastructure with a state-based Marketplace. Stand alone dental plans that offer at least the pediatric dental essential health benefits will be allowed to be sold on the Marketplace.

The Marketplace may provide basic information about vision or other ancillary insurance products on its website, such as explaining the type of coverage these products provide. The basic information must include the following disclaimers:

  • Enrollment in vision and ancillary insurance products does not constitute enrollment in a QHP or enrollment through the Marketplace but rather enrollment in a separate legally and publicly-distinct program.
  • Advance payment of premium tax credits and cost-sharing reductions are not available for vision or other ancillary insurance products.

The Marketplace IT infrastructure can be reused by other, separate non-Marketplace state programs to facilitate coverage in ancillary products, provided that certain conditions are met.

Where can I find more information?
More information can be found in the FAQ.

 

The information in this document is based on preliminary review of the national health care reform legislation and is not intended to impart legal advice. The federal government continues to issue guidance on how the provisions of national health reform should be interpreted and applied. The impact of these reforms on individual situations may vary. This overview is intended as an educational tool only and does not replace a more rigorous review of the law’s applicability to individual circumstances and attendant legal counsel and should not be relied upon as legal or compliance advice. As required by US Treasury Regulations, we also inform you that any tax information contained in this communication is not intended to be used and cannot be used by any taxpayer to avoid penalties under the Internal Revenue Code.

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