Many circumstances in life might force someone to switch health insurance plans. Moving, getting married, losing a job, starting a new career, and a change in financial status can all cause someone to need a new plan. While this may seem like a good thing if someone is able to upgrade to better coverage and more benefits, itâ€™s not always ideal for people who are moving from a high-deductible health plan.
Accumulators (a running total of money paid towards oneâ€™s out-of-pocket max for covered services) often play a large part in a personâ€™s decision to change to another health insurance plan. If someone (or a family member on their plan) has an active medical concern that they are seeking treatment for, chances are they have shelled out a great deal of money for co-payments, procedures, prescriptions, and the like. With these members being so close to getting a higher level of coverage once they hit their out-of-pocket maximum, they may put off beginning a new health plan until a later time.
This can not only cause a greater surge of new enrollments at the start of the year, but it may even mean that some members miss out on better coverage altogether. The American Rescue Plan and other subsidies can prove very helpful for people on a fixed-income or those who need family plans.
What many people may not realize is that the legislature surrounding accumulators has changed for the better. Many states have adapted their marketplaces so that each personâ€™s total out-of-pocket payments transfer from one health insurance plan to another. Itâ€™s important to note that this almost exclusively applies to people who choose new plans offered by the same insurer. However, this is still a large improvement from just several short years ago.
There is still room to grow in this issue. But 15 states (including Michigan, Minnesota, Washington D.C., Massachusetts, New York, and Wisconsin) have even gone as far as requiring insurers to honor accumulators from one of their previous plans. Other states, such as Alaska and California, have more complex policies surrounding the transfer of accumulators.
While this change benefits many people, they will need to do the math and determine whether or not their tax credit savings will make up for the loss of their out-of-pocket payouts. These complexities will likely make it more difficult for insurers, who must keep track of membersâ€™ previous accumulators and develop procedures to accurately move those to new plans in sufficient time. If these new changes do not impact your company, you can still get ahead of the curve by determining how plan switches stand to affect your enrollment numbers and trends.