Marketplace Payment Rules Finalized
Aug. 30—Insurers offering plans to individuals in the marketplaces set for launch at the beginning of 2014 will need to accommodate people without bank accounts or credit cards.
A final rule specifying the methods for insurance premium payments and other issues related to the insurance marketplaces, also known as exchanges, authorized by the Affordable Care Act was published in the Federal Register on Aug. 30. Among the marketplace details finalized with the rule were the standards for eligibility appeals, verification of eligibility for coverage, and clarifying the role of agents, brokers, and issuer application assisters in assisting consumers with obtaining marketplace coverage.
The final rule slightly expanded requirements in a proposed rule earlier this year that required insurers selling individual market plans to accommodate low income applicants without formal relationships with traditional financial institutions. The so-called unbanked could comprise one-quarter of those eligible for exchange subsidies, according to a May report by Jackson Hewitt, an accounting company.
Insurance companies were required by the rule to accept for all premiums a variety of payment methods, including money orders and pre-paid debit cards, which are popular among the unbanked, according to Hewitt.
The rule also gave states operating their own exchanges more flexibility to modify the appeals process timelines for determining eligibility for marketplace plan coverage or subsidies.
Publication Date: Friday, August 30, 2013