March 1, 2016
CMS Announces Transitional Relief Extension for Calendar Year 2017 
On Monday, February 29, 2016, CMS released a bulletin announcing an extension of the transitional period for non-grandfathered coverage in the individual and small group markets to comply with all provisions of the Public Health Service Act (PHS Act), including those related to single risk pools, no later than 2018.

This extension applies to health coverage in the individual and small group market that meets the criteria of the extended transitional policy and associated group health plans of small businesses, if applicable. This extension applies to policy years beginning on/or before October 1, 2017, provided that all polices end by December 31, 2017.

Since 2014, and specifically now, CMS has indicated they will work with insurers and States to implement this policy, including options such as allowing policy years that are shorter than 12 months or for early renewals with a January 1, 2017 start date.

States can elect to extend the transitional policy for shorter periods than outlined by CMS, but but may not extend it beyond December 31, 2017. States may choose to adopt the extended transitional policy in the following manner:
  • For both individual and small group markets;
  • For the individual market only; or
  • For the small group market only.
For additional details, please refer to the actual CMS bulletin:
Benefit Concepts Response 
Insurance carriers will be unable to respond and provide action steps until the State of Texas confirms or declines to extend the new transitional policy.

As soon as new information develops, Benefit Concepts will send an alert regarding the outcomes of any decision applied by the State of Texas or the carriers. Additionally, BCI will share a response, strategy, or action steps that prepare you and your clients for the future. 
Your Internal Resource 
Mark Mann
Marketing & Enrollment Manager
[email protected]                
(713) 728-7254 Direct  
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Benefit Concepts, Inc. 
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