Impacts all nongrandfathered fully insured plans, whether inside or outside the exchange, beginning with the 2014 plan year:
Guaranteed issue and renewal will apply to all insured plans regardless of size. Participation and employer contribution requirements will not be permitted under the guaranteed availability rules, although insurers may impose participation and employer contribution requirements at renewal. To ease the risk of anti-selection insurers may limit small groups that don’t meet participation or employer contribution requirements to an annual open enrollment period, from Nov. 15 to Dec. 15 each year. Additional strategies to combat anti-selection are being considered. A 30-day special enrollment period will be available both in and out of the exchange following COBRA qualifying events and a similar 30-day “limited open enrollment period” will be available if a person loses minimum essential coverage, becomes eligible or ineligible for premium tax credits/subsidies or moves out of the service area.
The text of the final rule on health insurance market reforms is here: http://www.ofr.gov/OFRUpload/OFRData/2013-04335_PI.pdf
