Extension of Transitional Policy for Non-ACA Compliant Plans (Extended)

50 West Town Street Third Floor – Suite 300 Columbus, OH 43215-4186 Mike DeWine, Governor | Judith L. French, Director (614) 644-2658 Jon Husted, Lt. Governor www.insurance.ohio.gov

BULLETIN 2022-01

EXTENSION OF TRANSITIONAL POLICY FOR NON-ACA COMPLIANT PLANS

Effective April 20, 2022

On March 23, 2022, the Center for Consumer Information and Insurance Oversight (“CCIIO”) issued an Insurance Standards Bulletin (“Bulletin”) extending CCIIO’s transitional policy through 2023 and later benefit years. Previously, CCIIO announced the extension of the policy on an annual basis each year. This time, however, the Bulletin states that the “non-enforcement policy,” will remain in effect until CMS announces that all such coverage must come into compliance with the specified requirements. Otherwise, the substance of the policy remains unchanged from previous years. As with previous transitional policies, this policy applies to non-grandfathered health insurance plans in the individual and small group markets that would otherwise terminate or require modification as a result of the federal health insurance market reforms required under the Patient Protection and Affordable Care Act (“ACA”).

In light of CCIIO’s extended transitional policy, insurers in Ohio may offer their insureds the ability to continue/renew non-ACA compliant individual and small group coverage, at the insured’s option. Insurers wishing to extend coverage shall follow CCIIO’s transitional policy, including federal notice requirements, offering reenrollment or extended coverage to impacted policyholders in the individual and/or small group market in a uniform and non-discriminatory manner in accordance with Ohio law (Ohio Revised Code (“ORC”) 3924.03 and 3923.57). Thus, renewals shall be treated uniformly and without regard to health status.

Please note that individual coverage includes sickness and accident insurance made available in the individual market to individuals, with or without family members or dependents, through group policies issued to one or more associations, trusts, or other entities. Small group coverage applies to employer-sponsored plans only.

To take advantage of CCIIO’s transitional policy, filings must meet the requirements specified below.

Filing Guidance For purposes of transitional policy rate filings, issuers must submit updated rates for approval by the Department. Filings must comply with all rate increase filing requirements, including, but not limited to, the submission of an actuarial memorandum that quantitatively supports all premium and trend factors and the actuarial soundness of

Accredited by the National Association of Insurance Commissioners (NAIC) Consumer Hotline: 1-800-686-1526 Fraud Hotline: 1-800-686-1527 OSHIIP Hotline: 1-800-686-1578 TDD Line: (614) 644-3745 (Printed in house) premium rates to be charged (ORC 3923.021 and 1751.12), and must comply with applicable federal law.

For purposes of form filings, issuers must submit updated forms for approval by the Department to incorporate state law changes, if applicable. All transitional policy filings must clearly indicate that they are being filed pursuant to this Bulletin.

Superintendent of Insurance

Judith L. French, Director