Bulletin, October 31, 2016, Guidance Regarding Auto Re-Enrollment

Last Updated: October 31, 2016

Date: October 31, 2016
To: All Insurers Authorized to Write Health Insurance in Wisconsin
From: Theodore K. Nickel, Commissioner of Insurance
Subject: Guidance Regarding Auto Re-Enrollment

​The Office of the Commissioner of Insurance (OCI) is issuing this bulletin to ensure all insurers participating on the federal healthcare exchange provide ample opportunity for consumers to make their own decisions regarding choice of insurer for their health insurance needs.

The Centers for Medicare and Medicaid Services (CMS) intends to auto re-enroll consumers into a different insurer's plan if their current insurer will not have plans available on the federal exchange in 2017. OCI believes CMS' plan to auto re-enroll these consumers violates state insurance law. Specifically, OCI is concerned that consumer's personally identifiable information and financial information will be shared with insurers who have not been selected by the consumer. Enrollment in a plan without a consumer's consent violates state law and the Affordable Care Act. In disregard of the Commissioner's repeated objections to the auto re-enrollment scheme, the federal government is proceeding with auto re-enrolling approximately 37,000 Wisconsin consumers this fall.

Insurers who receive notice from the federal government indicating consumers will be auto re-enrolled into one of their plans will not be found in violation of state insurance laws and regulations provided the insurer can demonstrate, upon request of the Commissioner, each of the following:

  1. Upon receipt of an auto re-enrollment file from the federal exchange the insurer attempted to contact the consumer as soon as practicable and, if possible, prior to the effective date of coverage to inform the consumer that the federal exchange auto re-enrolled the consumer to the insurer.
    • The insurer should provide the consumer with information about the federally selected plan including: premium, metal level, benefits, and network access.
  2. Prior to effectuating coverage for any auto re-enrolled consumer, the insurer obtained consent from the consumer affirmatively agreeing to be insured by the plan. Consent in this case includes, but is not limited to: obtaining a signature, the consumer actively selecting the plan through the federal Web site healthcare.gov, the insurer receiving the initial premium payment, or through other means consistent with s. 631.07, Wis. Stat.

Any questions concerning this bulletin should be directed to Elizabeth Hizmi at elizabeth.hizmi@wisconsin.gov.