CMS Announces Transitional Relief Extensions for 2017 Calendar Year

On Monday, February 29, 2016, CMS released a bulletin announcing an extension on 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. The 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 that 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 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 CMS Final Transitional Relief Bulletin 2.29.16.