SLCSP Changes and Consumer Notices

As of April 1, 2017, Maryland is changing how it calculates the Second-Lowest Cost Silver Plan (SLCSP) based on recent Federal guidance. The change will increase Advanced Premium Tax Credit (APTC) for approximately 18,000 Maryland enrollees.

A copy of a letter that is being mailed to consumers this week is copied below. This letter was printed in both English and Spanish. A system-generated 1303 (Notice of Eligibility) was also included in the consumer mailing, and electronic notices were loaded into HBX accounts.

The change is effective for 2017 and future plan years only.

Consumers may call or visit your storefront location for help understanding the letter/notice and how it affects their APTC. Only currently enrolled consumers received this notice.

If the consumer currently has no APTC and under the new rules will have any amount of APTC, a 60-day Special Enrollment Period (SEP) will start April 1, and the consumer may choose a different plan. New plan choices follow the 15th of the month rule. Please remember to discuss the impact of changing plans with the consumer, as accumulators are not transferable.

Consumers who already have an APTC amount but will be eligible to receive more APTC effective 4/1/17 will not have an SEP.

New APTC amounts will not apply retroactively. Consumers will be able to receive any additional APTC for which they may have been eligible for January-March when they reconcile taxes at the end of the year.

Below is the text of the letter being mailed to consumers this week regarding the 1303 Notice or available in their online account.

Dear Consumer,

We are contacting you with important information about your financial help through Maryland Health Connection.

As a result of recent Federal guidance for 2017, we changed the way we calculate the advanced premium tax credit (APTC) that lowers your health insurance costs to make coverage more affordable.

The change is effective April 1, 2017, and you should see the change in the April bill you receive from your insurance company. In some cases, it may take an additional month or two for the change to appear on your invoice. In the meantime, you should be sure to continue paying the amount billed.

When you file your 2017 tax return next year and report the tax credits you received this year, any additional tax credit you should have received in previous months will count as a credit.

The enclosed 1303 Notice indicates you made a change, even if you did not. It also may appear as if your coverage has been terminated, but it has not. (If you receive paperless notices in your Maryland Health Connection inbox, you have already received the 1303 Notice electronically.) You also may receive a 1403 Notice that says your enrollment is effective March 1. Your coverage is still effective, and your effective date has not changed. Only the amount of APTC your household is eligible for has changed, effective April 1.

If your household was not previously eligible for a tax credit but is now eligible, you may qualify to shop for a new plan during a 60-day Special Enrollment Period that starts April 1. However, it’s important to note that any contributions you already have made toward your plan’s annual deductible or other out-of- pocket costs would not transfer to a new plan. If you would like to change plans, please seek help from Maryland Health Connection using the information below:

You can get free, in-person help understanding this information and the options available to you from a certified navigator or authorized insurance broker. Visit MarylandHealthConnection.gov/help to search for local assistance, or call us at 1-855- 642-8572 (TTY: Deaf and Hard of Hearing use Relay service).

Sincerely,

Maryland Health Connection

Language services are available to assist you. If you need assistance, call 1-855- 642-8572 (TTY: Deaf and Hard of Hearing use Relay service). Servicios de idiomas están disponibles para ayudarle. Si necesita ayuda, llame al 1-855- 642-8572 (TTY: Deaf and Hard of Hearing use Relay service).

About “The Classroom”

“The Classroom” is Maryland Health Connection’s blog for its consumer assistance community, including navigators, authorized brokers, certified application counselors, caseworkers and call center staff. Check here for updates on training, website releases, new tools, and other helpful information as you help get Marylanders covered through the health insurance marketplace.

We encourage you to also subscribe to “The Connection” blog on MarylandHealthConnection.gov, which provides consumer-friendly information and updates. Be sure to follow us on Facebook, Twitter, Instagram and YouTube!

To suggest topics for The Classroom, email mhc.trainingsupport@maryland.gov.