Marketplace Coverage and Federal Protections

What this video covers

• Why comprehensive Marketplace plans cannot reject an applicant, charge more, or deny otherwise covered essential health benefit treatment because of a pre-existing condition under the Affordable Care Act (ACA)
• How group protections for similarly situated participants differ from aggregate premiums charged to an employer group
• Which services fall into essential health benefit categories, including why pediatric oral and vision care count but adult dental and vision do not
• Why losing job-based coverage can open a Special Enrollment Period, while receiving a new diagnosis does not
• How to confirm active coverage using the first premium payment, enrollment confirmation, and effective date
• When qualifying in-network preventive services have no cost sharing, and how grandfathered plans, eligibility rules, and diagnostic care can change coverage
• How comprehensive plans differ from short-term and fixed indemnity coverage, including medical underwriting and stated benefit limits