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Insurers say shutdown delays benefit plan design

Small insurer groups want the CMS to provide informal guidance on how they should craft plans for the 2020 Affordable Care Act exchanges because the official proposed rule is delayed due to the government shutdown.

The Association for Community Affiliated Plans and the Alliance of Community Health Plans wrote to the CMS on Tuesday pleading for information so they can prepare for the 2020 coverage year for the exchanges. The proposed Notice of Benefit and Payment Parameters for 2020 is “stalled at the Office of Management and Budget” due to the government shutdown, the letter said.

The previous proposed rule for the 2019 exchange coverage year was released in October 2017 and finalized in April 2018. The deadline for insurers to submit applications for the 2019 coverage year was May 2018, and a deadline for 2020 has not been decided yet.

The groups want the CMS “to issue informal guidance with parameters on what to expect or information on systems changes affecting (quality health plan) operations or templates and timelines for 2020 applications.”

A CMS spokesperson said the agency understands “the importance of giving issuers appropriate time to plan for the upcoming coverage years and are working towards issuing this rule.”

Any proposed rule will have to go through a 30-day comment period before it can be finalized, creating a further crunch for insurers if the administration keeps the May deadline to submit plan applications. The open enrollment for 2020 will likely resemble prior years and start in November.

“This timeframe will not allow issuers sufficient time to prepare products and operations for benefit year 2020,” the letter said.