The rule outlines standards for eligibility appeals, verification of eligibility for minimum essential coverage and handling incomplete applications. Additionally, it creates additional privacy and security protections for consumers and clarifies the role insurance agents, brokers and issuer application assisters will play in helping people purchase coverage through the exchanges. The rule also sets non-discrimination standards for premium payments methods, provides guidelines for handling consumer cases and issues regulations for the states’ operation of the exchanges.
Regarding the state exchanges, the final rule allows states to establish and operate small business exchanges without also running individual exchanges in 2014. The federal government will facilitate the individual markets in these states.
Many of the provisions contained in the 300-page final rule will take effect Oct. 1, when the exchanges open for enrollment.
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