Pennsylvania Association of

Community Health Centers

Supporting Pennsylvania's health centers in increasing access to quality primary health care for all

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Friday, August 03, 2018

Aug. 3, 2018 Outreach and Enrollment News

Potential Two-Year Delay on ACA Health Insurance Tax 

Last week the House of Representatives passed House Resolution 6311.  This would delay the Affordable Care Act's (ACA) annual fee imposed on health insurance providers through 2021. The bill also increases the maximum contribution for tax-advantaged health savings accounts (HSAs) and would allow anyone to purchase bronze plans and catastrophic "copper" plans that have high deductibles and low premiums, which are currently not available to consumers over 30 or those experiencing a justified hardship. For more information, click here


Questions on your CDO/CAC Refresh Application?

The Centers for Medicare and Medicaid Services (CMS) has provided FAQs on the Certified Application Counselor Designated Organization (CDO) refresh program.  The process to apply, get approval to return the executed contract and confirmation of your approval may take up to 30 business days.  After you have been approved to participate in the CDO program, each organization will be issued a new CDO number to distribute to your certified application counselors (CACs).  CACs are encouraged to wait 14 days to begin the training after receiving the new CAC number.  Should you have questions about the process, please contact Tia Whitaker, statewide director, outreach & enrollment.


From Coverage to Care (C2C) Prevention Webinar

Need information on prevention? Join C2C, HealthFinder, and CDC!  The Centers for Medicare and Medicaid Services (CMS) Office of Minority Health (OMH) in collaboration with the Office of Assistant Secretary for Health (OASH) Office of Disease Prevention and Health Promotion's HealthFinder team and the Centers for Disease Control's (CDC) Office of the Associate Director for Policy will host a webinar to provide information and resources that From Coverage to Care (C2C) partners can use to help consumers understand their health care coverage and use prevention services. To register for the Tuesday, Aug. 7, 2:00 pm webinar, click here.


Grace Periods and Termination Due to Non-Payment of Premiums

The health insurance grace period, a short extension of time for consumers to pay their monthly premium before their plan is canceled, is three consecutive months if both of the following are true:

  • The consumer has a Marketplace plan, qualifies for advance payments of the premium tax credit (APTC) and is using the APTC to lower his or her premium; and
  • The consumer has already paid the policy's first month's premium (called a "binder payment")

During the APTC grace period, the consumer's plan must pay all claims for the first month.  If the consumer doesn't pay all outstanding premiums before the end of the APTC grace period, claims in the second and third months become the consumer's responsibility. If a consumer isn't receiving APTCs to lower premiums, he or she may still qualify for a shorter grace period under rules set by their respective state.  If a consumer fails to pay all outstanding premiums by the end of the grace period, they may be terminated from a plan for non-payment and would then have to wait until open enrollment to enroll in a plan unless they qualify for a Special Enrollment Period. Consumers would not qualify for a Special Enrollment Period (SEP) due to loss of minimum essential coverage (MEC) because the "loss" (i.e. termination) was due to non-payment of premiums. For more information on grace periods, click here

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