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The Department of Health and Human Services has announced a new rule for the health insurance exchanges that will be established as of Oct. 1 under the Affordable Care Act. The new rules apply mostly to the appeals process for both consumers and employers. Importantly, the rules also require that insurance companies in the exchanges accept multiple forms of payment, including paper checks, cashier's checks, money orders, electronic transfers and prepaid debit cards.
One issue addressed by HHS is the appeals process for Americans who feel they should qualify for coverage or federal support under the individual insurance exchange but have been deemed ineligible by the government. In its release, HHS sketched out a "federally managed appeals process" where individuals will first go through a preliminary review and receive what the department is calling an "informal resolution." If the consumer is satisfied with the outcome, that decision would be viewed as final, but if not they may request a more formal hearing. [...]

Wednesday's release also outlines a separate appeals process for employers looking to appeal the government's assessment of the insurance plans they currently offer. Under the Affordable Care Act, all plans must meet federal standards for "minimum essential coverage." If the government determines that plans offered by a company don't meet those standards, under the new rules the employer may appeal that determination through either a state-run or federal process.

The payment options rule is critical for the growing number of low and moderate income people who don't have bank accounts, removing a potential big barrier to these people being able to actually purchase insurance. Additionally, HHS also clarified oversight and privacy protection issues, allowing HHS along with state insurance regulators to monitor the practices of plans participating on the exchanges for compliance with federal privacy standards.

Originally posted to Joan McCarter on Thu Aug 29, 2013 at 03:10 PM PDT.

Also republished by Daily Kos.

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