As required under the ACA, the federal government must conduct audits of Marketplace coverage to ensure that only people who are truly eligible are receiving a subsidized plan.

 

Effective Spring 2016, CMS launched an "Employer Initiatives" Program to aid in the auditing process. As part of this program, CMS may contact an employer to request whether or not one or more employees were enrolled in minimum essential coverage, or whether or not they were offered a health plan which was affordable and had minimum value. 

 

The President of the United States can have a significant impact on the shape and direction of health care, as has been seen with President Obama and the passage of the Affordable Care Act (ACA). The American people will cast their vote for the next President of the United States on November 8, 2016. The future of the health care industry will largely be influenced by the outcome of the election. Here is a very high level summary on how the presidential candidates have suggested they would change the health care industry:

 

We can categorize health insurance plans in a number of different ways. There are fully-insured and self-insured plans, HMOs and PPOs, high deductibles and low deductibles, and metallic tiers (bronze, silver, gold and platinum) which are used in some market segments. There’s also one other way to categorize health insurance plans, and that’s by their “grandparent” status. The grandparent status determines which Affordable Care Act (ACA) rules a health insurance plan must comply with.

 

The Centers for Medicare and Medicaid Services (CMS) recently announced a new process that will impact anyone seeking to enroll with a special enrollment period (SEP) on the Healthcare.gov website.  Under the current process, individuals who experience a qualifying event simply need to check a box on the application to be eligible for an SEP.