Commentary

Alternatives to ACA Compliant Plans in the Individual Market

This piece investigates each of the non-ACA-compliant plan types and provides a brief description along with current estimates of enrollment or projected enrollment.

Non-ACA-compliant health plans, which the Academy of Actuaries includes on its list of “major drivers of 2019 premium changes,” may be the greatest factor affecting market stability. These plans include Association Health Plans (AHPs), Short-Term Limited Duration plans (STLD), Agriculture/Farm Plans, and religiously based, pre-paid coverage plans, or “Sharing Ministries.”

The alternative plans are cheaper than existing products, but they are not required to cover pre-existing health conditions, to maintain minimum medical loss ratios, to cover essential health benefits, or to not discriminate in rating based on gender and health status. With the individual mandate tax penalty is no longer enforced, enrollment in non-compliant plans may soon be growing more rapidly.

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