QUESTION

I got this notice that says I can renew my insurance plan, which I've had since 2013. Should I renew? What are the benefits and disadvantages of doing that?

Coverage for small employers | Changes to Small Employer Coverage
ANSWER

Your notice likely relates to the renewal of a transitional or grandmothered policy, which can be either an individual or small group health plan. Under current federal policy, these plans, which existed prior to the implementation of the Affordable Care Act’s insurance reforms, do not have to meet certain provisions of the ACA. States can allow these types of health plans to be renewed until October 1, 2018; however, transitional policies cannot extend past December 31, 2018. Insurers that offer these plans must provide the following information in their renewal notices

The advantage of renewing is that you can continue in your health plan if you like it and you believe it provides coverage of the services and providers you need. The disadvantage is that these plans don’t have to comply with ACA consumer protections like providing coverage of ten categories of health services referred to as essential health benefits, limiting out-of-pocket costs, and not discriminating based on health or gender when setting premium rates. Also, you may be eligible for financial assistance that is only available when you buy a health plan through the marketplace. See this FAQ on additional information about financial assistance. (CMS, Insurance Standards Bulletin Series - Extension of Transitional Policy Through Calendar Year 2018, Feb. 23. 2017).

Individuals with no coverage
Individuals with coverage
Coverage for small employers
Post enrollment issues