Video instructions and help with filling out and completing Who Form 1094 B Eligible

Instructions and Help about Who Form 1094 B Eligible

Renewal but presenting today is Joanne VOC from the center on health insurance reform at Georgetown University Health Policy Institute let's welcome Joanna whatever one thing thank you thank you for taking the time everyone to join us in some to this webinar I'm sure you're you've heard that we are now about a week and a half into open enrollment period for coverage in 2015 and you may have also heard that there's a process for people who are in marketplace plans to renew their coverage we're going to cover today what's involved with that process and what to watch out for so there are two different pieces going on here with renewal one is that the Affordable Care Act requires health insurance companies to renew coverage for everyone that's already got a plan to allow them to continue into that plan the other process going on at the same time as rida terminan eligibility for financial assistance if people had premium tax credits with their coverage last year for the renewal of your marketplace plan notice qualified health plans or QHPs as i said the Affordable Care Act requires insurers to provide coverage to anyone that applies regardless of their health status or pre-existing conditions and then at the end of the plan year to automatically renew it in the past insurers used to cancel coverage if they didn't like the claims that we're coming in on someone that's no longer an option so the insurer must renew the person in the same plan if that plan is available but if it's not available the law gives the insurer some flexibility to substitute a similar plan or product based on federal rules without line how they can make substitutions so you end up in the plan that's similar to the one you had last year if the one you have last year is no longer available the consumer does not have to take any action to stay enrolled in the plant they can be automatically and enrolled without doing anything but here's the thing we recommend that all consumers should take action to review their plan and you must update your eligibility information make sure you're getting the right premium tax credit if even if you decide to keep the same plan but update your premium tax credit information you actually have to reflect the plan it's a two-step process you must do both parts to enter 2015 with the plan and a premium tax credit so quick question why does me ensure get to put me in a different plan well it's long been the case that insurers can cancel the plans are offering but once they decide to offer a particular plan they are not obligated to offer it forever if they decide for whatever reasons for business reason to no longer offer that plan they still have to renew you in some plan and so the law gives them some flexibility to determine what plan that would be it does have to follow certain rules to make sure that it is as close to the old plan as possible but it will be different so all the rules that were in existence before still apply now right which I'm pirate rules the QHP rules yes all the same rules apply for all the protections in the marketplace plans as existed before so all the plans have to still meet all those rules but there may be some differences and how the cost-sharing is done or provider networks it may be a different plan and still comply with all the rules thank you okay now the marketplace is going to send out notices to all QHP enrollees what there are different types of notices that are outlined in federal rules that the insurers have to follow so these should all look the same for consumers if the consumer is going to be auto renewed in the same product they can do so in the same product and there may still be some changes to the plan they have to make note of what those changes would be they can renew them in the same plan but actually in a different metal level is one of the options for insurers they can also auto renew the person in a totally new product a different product line so for example an HMO instead of a PPO and that may be in the same metal level have significant changes so you've gone from a silver PPO to a silver HMO would be the type of change that this notice would address and then finally if a plan about insurer is no longer offering a product any products on the market place then the consumer will have to take action to retain coverage because the insurer is no longer offering product okay the other process is going on as I said is not just renewing your plan but renewing your financial assistance if you're someone I qualified for premium tax credits and potentially sharing reductions that reduce the out-of-pocket costs the marketplace is not going to automatically update your eligibility for mania my credit macross sharing reductions they're basically going to carry forward the level of assistance you had in 2014 to apply in 2015 most consumers fall into this bucket where they will get the same tax credit as they had the previous year if they don't take action all consumers who authorized the IRS to check their latest tax data which is more than ninety eight percent of the applicants check the box that said go ahead and check my data the federal marketplace will look at their current fpl federal poverty level based on their 2014 income and make a determination about their tax credit and then depending on this information the consumer may receive a outreach message or special notice that calls out that they need to pay particular attention because of what the IRS