With much fanfare, the first open enrollment of health care reform ended on March 31, 2014. The initial tally indicates that more than seven million people gained insurance as a result of the new law. During the course of the next several months we will learn exactly who gained insurance, from what sources (state and federal exchanges, Medicaid and employers) and who did not. No politics here…just the facts.
Now that all the hoopla is over, what do you need to know? Well, first of all, while “open-enrollment” is officially over, there are still opportunities to enroll under certain conditions. These provisions are called “Special Enrollment Periods” or SEP. Here are examples of common events that would create a SEP: marriage, having a baby, adopting a child or placing a child for adoption or foster care, changing your residence, gaining citizenship, leaving incarceration.
- Losing other health coverage – due to losing job-based coverage, divorce, the end of an individual policy plan year in 2014, COBRA expiration, aging off of a parent’s plan, losing eligibility for Medicaid or CHIP, and similar circumstances. Important: Voluntarily ending coverage doesn’t qualify you for a special enrollment period. Neither does losing coverage that doesn’t qualify as minimum essential coverage.
- For people already enrolled in Marketplace coverage: Having a change in income or household status that affects eligibility for premium tax credits or cost-sharing reductions.
- Gaining status as member of an Indian tribe. Members of federally recognized Indian tribes can sign up for or change plans once per month throughout the year.
As you can see, the door is still open for many people throughout the year. If you qualify for a SEP, you will have 60 days from the date of the event to enroll in a plan. Remember, you can enroll online or with the assistance of an exchange certified insurance agent – there is no difference in cost. Also, it is important to note that your coverage will start at the first of the month following enrollment as long as it is completed before the 15th of the month. Otherwise enrollment will begin the first of the following month.
If you have any questions, feel free to call the team at Benefit Logic! FBN
Written by Ed Gussio