On June 28, 2021, the Department of Health and Human Services (HHS) proposed new rules that would primarily impact individual health plans that are sold through Health Insurance Marketplaces. The proposed rules aim to lengthen the annual enrollment period, expand Navigator duties, and minimize any burden or confusion for consumers. A summary of some of the key provisions has been outlined below:

Annual Enrollment Period

The proposed rules would expand the annual enrollment period by 30 days. The proposed rules would create an annual enrollment period that would start on November 1st and end on January 15th for the 2022 plan year and beyond. This change would apply to plans sold on and off a Health Insurance Marketplace. 

New Monthly Special Enrollment Period

The proposed rules would give Health Insurance Marketplaces the option to provide a new monthly special enrollment period. If implemented by a Health Insurance Marketplace, consumers with household income of up to 150% of the Federal Poverty Level (FPL) may be able to enroll in a plan during any month of the year and receive an advanced premium tax credit.

Navigator Program

Navigators receive federal grants to reach underserved and vulnerable populations to increase awareness about coverage options on the Health Insurance Marketplace. The proposed rule would increase funding for the Navigator program and expand the number of activities Navigators can perform.

Exchange User Fees

The proposal calls for a 2.75% user fee of premiums for plans sold on the federal Health Insurance Marketplace, and it calls for a 2.25% user fee of premiums for plans sold on a state Health Insurance Marketplace. This is an increase from previously proposed user fees, and the rationale is that the increase is necessary to increase funding for the Navigator Program.

Exchange Direct Enrollment Option Repeal

The proposed rule would repeal direct enrollment options for Health Insurance Marketplace coverage. According to the rule, "Consistent with many public comments received when the Exchange DE option was proposed, we believe that shifting away from HealthCare.gov or State Exchange websites as the primary pathway to enroll in and receive information about coverage would harm consumers by unnecessarily fracturing enrollment processes among the exchange and possibly multiple direct enrollment entities operating in a state."

For more details about the proposed rule, please click here.