In light of recently obtained information from the Centers for Medicare and Medicaid Services (CMS) regarding transitional policies, the Office of the Commissioner of Insurance (OCI) is issuing this bulletin to ensure all carriers have the benefit of the most recent interpretations regarding transitional plans. As you are aware, OCI issued a bulletin on March 20, 2014, on this topic and provided additional clarification in a communication dated May 14, 2014. Additional information indicating greater flexibility from CMS for issuers offering transitional non-ACA compliant products has recently been conveyed.
The new guidance on transitional plans extends the use of transitional plans through December 31, 2017, allowing for plan years that extend beyond 12 months. Specifically, the guidance not only permits the extension of the plans but also allows insurers to extend an annual policy through December 31, 2017, so that consumers are not left with a gap in coverage from the date of policy renewal to the end of the year.1 OCI encourages insurers to work with small employers and consumers to ensure smooth transitions. OCI will monitor plans to ensure that during the extended coverage period premium and cost-sharing are continued without resetting or rating if the only change is the extension through December 31, 2017.
This guidance is being shared with all insurers authorized to write health insurance coverage to continue Wisconsin's strong, level and competitive market.
Any questions concerning this bulletin should be directed to Diane Dambach at
diane.dambach@wisconsin.gov.
1 CMS guidance can be found at
https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/final-transition-bulletin-2-29-16.pdf.