Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: June 14, 2017

Program Area: Enrollment and Eligibility (ENR)

Question: Under the changed interpretation of 147.104, guaranteed availability of coverage, if an issuer decides to adopt the policy that attributes new premium payments to past-due premiums from the previous 12 months, does the issuer need to wait until the regulation takes effect on June 19, 2017 to notice the enrollee on the future consequences of non-payment?

Answer: No, the issuer may send the required notice to subscribers described in the preamble to the Market Stabilization final rule now. It must notify enrollees of the impact of non-payment on future enrollment. The issuer may then apply the new payment policy to properly noticed subscribers for applicable past due premium acquired after June 19, 2017.

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