March 22, 2016
On March 16, 2016, Insurance Commissioner Nickel issued a bulletin regarding transitional policies. As discussed in the March 8, 2016, edition of Compliance Corner, CMS announced an extension for small group transitional policies. Such policies are not required to be in compliance with certain PPACA mandates including community rating, coverage of essential health benefits, prohibition on pre-existing condition exclusions and the annual out-of-pocket maximum limit. The policy must have been in place on Dec. 13, 2013.
The bulletin confirms that insurers in Wisconsin have the option of renewing non-PPACA compliant small group glans on or before Oct. 1, 2017. Employers are permitted to change from one non-compliant plan to another if the new plan was available for purchase before Dec. 31, 2013. The plans must be the same type of product with the same benefits, insurer and primary network.