Extension of Transitional Plans through December 31, 2019
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Idaho Department of Insurance Bulletins › Extension of Transitional Plans through December 31, 2019
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State of Idaho
DEPARTMENT OF INSURANCE
C.L. “BUTCH” OTTER
Governor
700 West State Street, 3rd Floor
P.O. Box 83720
Boise, Idaho 83720-0043
Phone (208) 334-4250
Fax (208) 334-4398
Website: https://doi.idaho.gov
DEAN L. CAMERON
Director
Equal Opportunity Employer
BULLETIN NO. 18-03
DATE:
April 19, 2018
TO:
Disability/Health Insurance Carriers in Group or Individual Markets
FROM:
Dean L. Cameron, Director
SUBJECT:
Extension of Transitional Plans through December 31, 2019
This bulletin to carriers in the employer and individual health insurance markets provides
guidance regarding the extension of non-grandfathered transitional plans (also known as
“grandmothered” plans) through December 31, 2019.
Bulletin No. 13-05 addressed carriers continuing to offer transitional individual and small
employer policies in existence on October 1, 2013 at their 2014 renewal. Subsequent federal
guidance allowed for further extensions of these plans, which the Department chose to allow.
Bulletin No. 16-03 set forth the requirements for extension of transitional plans through
December 31, 2017, and Bulletin No. 17-01 allowed for extension of these plans through
December 31, 2018.
The latest CMS guidance, released April 9, 2018, allows states the option of extending the
transitional plans for an additional year, through December 31, 2019.
Transitional plans in the Idaho individual and small group markets will be permitted to extend
through December 31, 2019. Based on the requirements of Bulletin No. 16-03 and Bulletin No.
17-01, all transitional plans must now be on a calendar year renewal schedule. Carriers offering
these plans must offer policyholders a renewal for the 12 month period beginning January 1,
2019
r 31, 2019.
Transitional plans in the Idaho individual and small group markets will be permitted to extend
through December 31, 2019. Based on the requirements of Bulletin No. 16-03 and Bulletin No.
17-01, all transitional plans must now be on a calendar year renewal schedule. Carriers offering
these plans must offer policyholders a renewal for the 12 month period beginning January 1,
2019.
The transitional plans must continue to comply with the following ACA provisions:
Elimination of annual dollar limits on EHB as defined by the Idaho benchmark plan, to
the extent the transitional plans cover EHB
No pre-existing condition exclusion (small groups)
Waiting periods not to exceed 90 days (small groups)
Mental health parity rules (individual plans upon renewal July 1, 2014 or later; not
applicable to small group plans)
2
Carriers are required to provide a notice at renewal which informs the individual or small
employer of the option to renew the existing coverage or to enroll in a new plan on or off Your
Health Idaho, and also includes the information that some ACA market reforms are not included
in their current plans. The notice, available on the Department website, must be used without
modification, and must be mailed without any other materials except for a cover letter, which
may include the renewal premium.
If you have questions concerning this bulletin, please contact the Department of Insurance at
(208) 334-4250.
This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.