Enrollment and Eligibility (ENR) FAQ
Guidance for FAQ regarding Premium Payment and Premium Payment Methods
Program Area: Enrollment and Eligibility (ENR)
Question: Can issuers charge fees on the member portion on or off the Marketplace, regardless of payment type or specific to payment type?
Answer: An issuer cannot and may not pass on fees, such as credit card fees, to only a certain section of the consumer group. If an issuer wants to charge consumers such fees, the fees would have to be considered an administrative expense and made as a plan-level adjustment when developing the rate for the product, consistent with the Health Insurance Market Rules and Rate Review Final Rule (http://www.gpo.gov/fdsys/pkg/FR-2013-02-27/pdf/2013-04335.pdf). We note, however, that an issuer may only add such an expense to the rate with the annual filing (in the case of the individual market) or annual/quarterly filings (in the case of the small group), so no changes will be allowed at this time.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: June 24, 2014
HHS is committed to making its websites and documents accessible to the widest possible audience, including individuals with disabilities. We are in the process of retroactively making some documents accessible. If you need assistance accessing an accessible version of this document, please reach out to the guidance@hhs.gov.
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.