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

CCIIO releases FAQs

Oct. 18, 2013

On October 4, the Center for Consumer Information and Insurance Oversight (CCIIO) released answers to four frequently asked questions about Medicare beneficiaries and the Marketplace. The answers clarify that issuers, brokers and agents may not knowingly sell a Medicare beneficiary a qualified health plan (QHP) on the Marketplace. Such persons can however enroll in a QHP available on the Small Business Health Options Program (SHOP) available to small employers.

In order to protect themselves, the guidance identifies that agents and brokers may ask applicants about Medicare status. CCIIO plans to update its training materials to reflect this clarification.

It is not clear at this time whether persons entitled to and not enrolled in Medicare can purchase an individual QHP on the Marketplace. Blue Cross Blue Shield of Michigan will continue to monitor and advise when new information is received.

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.