Last month, the Department of Health and Human Services (HHS)—with help from the National Association of Insurance Commissioners—proposed a new rule that would essentially automatically re-enroll health insurance beneficiaries who obtained their plans via an exchange or marketplace. According to this article, HHS thinks this system could ensure continuity of coverage, reduce administrative complexity, and protect insurers’ market share. However, some, like Elizabeth Carpenter, the director of Avalere Health, believe that individuals may benefit from switching plans: “Most enrollees in 2014 chose a plan based on the monthly premium,” Carpenter says. “However, the lowest cost plans in 2014 may no longer be low cost in 2015.”
In the rule, the Centers for Medicare & Medicaid Services (CMS) explains how exchanges and insurers should verify and contact members to auto-enroll them (if they are happy with their current coverage and do not wish to make a switch). State-managed exchanges may use CMS’s federal model or create their own.
HHS Secretary Sylvia Mathews Burwell says, “As we plan for open enrollment in year two and continue to build a sustainable long-term system, we are committed to simplifying the experience for consumers by allowing auto-enrollment. We are working to streamline the process for consumers wishing to remain in their current plan.”
According to this article, the department is looking to emulate the group insurance market, “where many employees are auto-enrolled in their plans year after year.” The hope is that the auto-enrollment program encourages beneficiaries to evaluate their upcoming coverage needs, so they can choose the best carrier and benefit levels.
If the proposed rule becomes final, health plan members who are using federally-facilitated exchanges will receive notification regarding how to update their personal information. After eligibility is calculated (based on the updated information and tax returns), the exchange will automatically re-enroll participants in their current plans and notify them about any premium changes. Per the rule, it would be the insurers’ task to explain the auto re-enrollment process to participants.
In the same article, the author points out that exchange participants may have to choose between paying a higher premium to keep their current plans and selecting new plans (“with new networks and drug formularies”) to keep their premiums low.
To read the proposed rule in full, check out this PDF. It will be open for comment until late July. From the provider perspective, what do you think? Is auto re-enrollment a good idea?
