Friday, May 16, 2014

NEW COBRA Guidance

Typically, the rules for dropping COBRA are as follows: Yes, you can drop COBRA inside Open Enrollment, get a Marketplace Plan and be eligible for tax credits/subsidies even if your COBRA hasn't expired. No, you can't do the same thing outside of Open Enrollment--if you voluntarily drop COBRA outside of Open Enrollment, you typically are not be eligible for a Special Enrollment Period, so you couldn't get into a Marketplace plan, without a separate qualifying life event. If your COBRA expired outside of Open Enrollment, you WOULD be eligible for a Special Enrollment Period and thus could also be eligible for tax credits/subsidies.
But Wait: New Guidance: HHS will allow current COBRA  enrollees a chance to drop coverage and enroll in a marketplace plan by way of a special enrollment period. The last day to select and enroll in a marketplace plan through this SEP is July 1. Anybody currently in a COBRA plan who wants to switch to a marketplace plan should call 1-800-318-2596 and “inform the Marketplace call center that they are calling about their COBRA benefits and the Marketplace.” Once the person is determined eligible for the SEP, they can either continue enrollment and plan selection over the phone, or use an existing account, or create a new account and complete enrollment online.
Video Case Tip: The Penalty Grace Period

Who is eligible for a "grace period" for paying Marketplace Plan premiums? What other criteria need to be fulfilled? How long do you have to pay your premiums before you lose coverage? In this Video Case Tip, we look at the grace period rule.
Click Here or on the picture to the right to watch our Video Case Tip! What problems are you seeing in your area? Send your questions or comments in an email, and we'll create a follow-up webcast filled with the answers!
All our videos are archived in our growing "Video Case Tip Library" so you can visit them at any time.

The Case of the Missing BC+ Numbers


Several weeks ago, the Feds released data about the initial Open Enrollment period for the Federal Marketplace. Now, heads have turned to Wisconsin's Department of Health Services to evaluate their April enrollment data for BadgerCare Plus programs. But there's one problem: the numbers are missing. HealthWatch retained Inspector Clouseau for the case. 😉 He's looking high and low for the numbers--in office closets and shredding rooms, air vents and bathrooms. But our inspector recognizes that forces within DHS might hold tight to the numbers until no one is looking. For example, we might see the numbers released late in the day on Friday, May 23, just before the long Memorial Day weekend.
In this edition of the Update newsletter, we talk more about BadgerCare Plus as well as more reaction to the first Open Enrollment period in the Marketplace, including comments from Region V Director Falk. Miss the new guidance on coordinating COBRA coverage and ACA coverage? It's in here--under the new term we've coined, "COBRAMACARE!" Not sure about the penalty for not having insurance? It's in this Update's "Video Case Tip."  We also get you caught up on provider memos, Ops Memos, and the new release of the BadgerCare Plus Handbook. There was breaking news today out of the VA--we look at that too. Of course, we bring you case tips and a news round-up, per usual!
Thanks to all of the current members, subscribers, and supporters--you make the HealthWatch Update possible!
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State Audit of Medicaid Transportation Issues: Share Your MTM Story

The Wisconsin Medicaid Transportation Program and vendor will face a state audit. Auditors are encouraging members of the public to contact them or the Legislative Audit Bureau directly with complaints and other information that they think should be included within the audit.
The Legislative Audit Bureau wants individuals with complaints or experiences with MTM to contact the LAB hotline (1-877-372-8317) to get an accurate picture of the quality of services MTM is providing. The Audit Bureau is online: