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Need a ACA compliant Health Plan? What does this mean?

The policy for individuals or a small group must obey ACA regulations. No annual lifetime coverage maximums or annual maximums and has to include 10 essential health benefits in the policy coverage.

It’s what is referred to as a “Guaranteed Issue” which is any insurance coverage “guaranteed” to be “issued” to any applicant no matter what their health status is, their age or income. It is to guarantee that the policy is renewed provide the policy holder has continued to pay their policy premium.

This is during the open enrollment period. Carriers have to comply with MLR rules which is “Medical Loss Ratio” and are required to spend on medical expenses at least 80 % of the premiums and 85% on large premiums some larger group plans.

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