Filed Under:Markets, Employee Benefits

HHS sets complicated fixed indemnity rules

Outgoing HHS Secretary Kathleen Sebelius (AP photo/Al Behrman)
Outgoing HHS Secretary Kathleen Sebelius (AP photo/Al Behrman)

Insurers may have a chance to sell fixed indemnity health insurance to workers who get weak "minimum essential coverage" (MEC) from self-funded employee health plans.

States cannot paralyze navigators by wrapping them in red tape -- but they may be able to put some red tape around "certified application counselors" and other "non-navigator assistance personnel."

In the new final regulations, HHS has decided that consumers who buy fixed indemnity coverage must have MEC.

But insurers need not verify whether or not the buyers actually have MEC. Insurers simply must have the buyers state that they have MEC, CMS officials write in a preamble to the regulations.

In the draft regulations, HHS said states could establish local standards, but not standards that interfere with what HHS believes to be exchange helpers' statutory duties.

In the final regulations, HHS makes a clear distinction between the standards for the exchange navigators -- who play a role that was explicitly created by PPACA -- and other types of exchange helpers, who have been created by HHS, state insurance regulators, and state exchange program managers.

Originally published on BenefitsPro. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.


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Nichole Morford

Nichole Morford
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