Departments refuse to accept the proposition that notification should not be part of the definition of short-term and fixed-term insurance, but rather should be subject to a separate requirement once a policy meets the definition of short-term and limited-term insurance. Departments do not believe there is a compelling reason to change the regulatory structure in this way. Departments also refuse to accept the proposal to use a notice of disclosure, regardless of the year the directive was issued. As previously mentioned, the payment amount for individual joint liability for the months beginning in January 2019 is $0. For short-term, limited-term policies covering the months prior to January 2019, the departments consider it essential that the Notice of Disclosure inform applicants and policyholders that they may be held liable to pay individual joint liability given the potential financial consequences of not maintaining CME during this period. However, for policies that do not cover such a month, such language would not only be irrelevant, but departments feel that it could be confusing. The sections also note that the wording of both notices is literal, with the exception of the last two sentences (which may not be included in communications provided with short-term term insurance policies whose coverage begins on or after January 1, 2019). As a result, the departments consider that the burden associated with the two disclosures, which apply at different time periods, is outweighed by the benefits of mitigating the likelihood of confusion for consumers that could result from maintaining the last two sentences of the Notice if they are intended for policies with an expiry date of January 1, 2019 or later. Many commentators suggested concrete changes to the content of the notices. Some commenters suggested adding details to the notice, such as which benefits are not covered by the plan, whether pre-existing conditions are covered, what AAPP protections are not applicable, and making it clearer that the loss of short-term term insurance will not trigger a specific filing period in each market.
Several commentators explained that the opinion was intended not only to distinguish short-term and time-limited insurance from the individual market plans available, but also the former of the exempted benefits. Some commentators suggested that the notice be available in several languages. One commenter explained that the notice was intended to illustrate how certain conditions would be covered. Several commentators stated that communication should not be done in capital letters. Some commenters stated that the notice should inform consumers that if they decide to purchase short-term, time-limited insurance after the policy expires, they will be purchased again, while another commenter stated that the notice should state that even if the consumer purchases reinsurance, they may not be insured for health conditions. That covered the previous policy. Some commentators explained that the notice was intended to indicate that purchasers of short-term, limited-term insurance may not be eligible for CTPs (although some purchasers of eligible health plans sold on the stock exchange may not). One commentator explained that the notice was intended to say that the directive “does not meet” the requirements of the AAPP and “is not obligated to comply with them.” One commenter explained that the ad should have a WARNING title, be bulleted, be written in dark color, be literate at Grade 6 reading level, and MEC should be listed first. One commenter explained that the notice should appear on the first page of the policy instead of being posted “prominently.” One commenter explained that printed page 38224 stating that short-term, time-limited insurance may not comply with the AAPP and may require additional payment with your taxes should be removed.
One commenter noted that in addition to PPACA, short-term and time-limited insurance is also exempt from other specific federal laws and that this should also be included in the notice. Another commenter recommended that the notice include a link to the appropriate state`s website or Exchange HealthCare.gov. On the basis of a review of general and legal dictionaries and case law, it is very difficult to argue that a particular expression that does not use certain units of time has a precise meaning that should be used in a particular situation to the exclusion of other expressions. For example, legal dictionaries tend to treat “promptly” and “immediately” as the same meaning. Another factor that adds to the confusion is the use of variations of expressions that may convey the same meaning. For example, there are the terms often used “as soon as practicable”, while the expressions “as soon as practicable” and “as soon as reasonably practicable in the circumstances” have been used. The departments note that Congress did not amend the existing reference to short-term and time-limited insurance as an exclusion from the PHS definition of “individual health insurance” or did not address short-term, time-limited insurance in PPACA, suggesting that Congress did not address short-term, time-limited insurance that coexists. at least according to the standard in force before the regulation of October 2016. with individual health insurance. The departments consider that a maximum duration of 36 months for short-term and time-limited insurance is compatible with these two co-existing insurance markets, while giving importance and impact to the “term” component of short-term limited-term insurance. The departments sought input on all aspects of the proposed regime, including whether the duration of short-term term insurance should be different. In addition, the departments sought comments on regulations, other guidelines or guidelines that limit issuers` flexibility in the design of short-term and fixed-term insurance or create barriers to entry into the short-term and fixed-term insurance market.
In addition, the departments specifically solicited comments on the conditions under which issuers should be able to continue to purchase short-term, fixed-term insurance for 12 months or more with the issuer`s consent and on the revised notice. Today`s regulation provides consumers with more affordable health insurance options. You will now have the option to purchase short-term, limited-term insurance policies that: The departments also disagree that the definition in the proposed rule and as revised in this final rule is inconsistent with the CAPP. Both the proposed rule and the final rule set federal standards for short-term, fixed-term insurance in a manner that clearly distinguishes that insurance from individual health insurance, which is subject to PPACA`s individual market requirements. In addition, there are no explicit legal standards for Start Printed Page 38216 on the extent to which short-term fixed-term insurance should deviate from individual health insurance coverage, leaving it to departments to use their interpretive power to distinguish between the two terms. When federal regulations on short-term and fixed-term insurance were first implemented in 1997, short-term term insurance was considered health insurance coverage with a coverage period of less than 12 months, as under the proposed Regulations. This standard has applied for almost two decades without objection.