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Open Enrollment Period

Overview

The open enrollment period for the 2015 plan year (and later) will begin on November 15th and end on February 15th. Those desiring coverage beginning January 1, 2015 must enroll by December 15, 2014.1 People experiencing events that change their circumstances during the year, such as childbirth or job loss, may qualify for a special enrollment period outside of the annual open enrollment period.

Insurance applications submitted by December 15th shall become effective by January 1st. Insurance applications submitted after December 15th during open enrollment shall become effective according to the following rules:

  • Applications submitted between the 1st and 15th days of the month shall result in coverage beginning the first day of the following month
  • Applications submitted between the 16th and the last day of the month shall result in coverage beginning the first day of the second following month

The Affordable Care Act created a new open enrollment period for individual and family health insurance plans. The first open enrollment period was longer than in future years in order to give consumers a chance to understand their options and make a selection. Consumers were able to begin enrolling in new health plans on October 1, 2013. In order for their plan to be effective on January 1, 2014, an application for coverage needed to be submitted by December 24, 2013. The open enrollment period for 2014 was initially scheduled to end March 31, 2014 in every marketplace, but this deadline has been extended for most marketplaces.

Enrollment into an on-exchange qualified health plan can be performed through a health exchange marketplace, an insurance company that sells plans on an exchange, or an insurance broker that is qualified to sell plans on the exchange.

State-by-state open enrollment deadline extensions

The open enrollment period for health insurance coverage starting in 2014 was initially scheduled to run between October 1, 2013 and March 31, 2014 in all fifty states and the District of Columbia. Thirty-six states have federally-facilitated marketplaces in 2014 through healthcare.gov, while the District of Columbia and the other fourteen states run their own state-based marketplaces.

Due to low enrollment numbers, technical issues with health insurance exchange websites, and many anticipated last-minute enrollments, most states extended their enrollment deadlines during the last week of March. These extensions will delay deadlines for some enrollees up to two or three months. The table below displays current information on the extensions in every marketplace.

Federally-facilitated marketplacesExtension
Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Louisiana, Maine, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, WyomingConsumers who tried to enroll during the open enrollment period, but did not complete the process by March 31, will have until April 15 to finish the enrollment process. People whose paper applications are received by April 7 will be able to select a plan through April 30.2
State-based marketplaces
CaliforniaIndividuals who start an application by 11:59pm on March 31, 2014 will have until 11:59pm on April 15, 2014 to complete their application and select a plan. Paper applications must be postmarked by March 31, 2014.3
ColoradoConnect for Health Colorado will help customers to complete enrollment if they tried to apply by March 31. Customers who applied during open enrollment but did not receive an eligibility confirmation until after March 31 will have until May 31, 2014 to enroll through Connect for Health Colorado.4
ConnecticutThe Chief Executive of Access Health CT stated that residents that called the Access Health CT center and left a message by midnight on March 31 could receive an extension.5
HawaiiThe interim executive director of Hawaii Health Connector said individuals and families would have more time to complete the enrollment process if they started an application by March 31.6
KentuckyResidents have until April 15, 2014 to select a plan if they submitted an application for coverage on or before March 31.7
MarylandAnyone that attempted to enroll before March 31 will be able to call 1-800-396-1961 to tell Maryland Health Connection that they started an application but were unable to complete it. Anyone who calls by March 31 will receive “special assistance” to enroll in a plan with coverage starting May 1, 2014.8
MassachusettsPeople applying for coverage with help paying for costs can apply at any time during the year if they miss the March 31 deadline.9 People applying for coverage without help paying for costs, that were unable to complete enrollment because of system issues such as website errors, will have until April 15, 2014 to enroll.10 Moreover individuals that were enrolled in non-ACA-compliant temporary state-run plans because the exchange could not process their applications on time will have until June 30 to switch to a qualified health plan.11
MinnesotaPeople can submit an Enrollment Attempt form or call the Contact Center at 1-855-366-7873 to inform MNsure that they tried to get coverage before March 31, 2014. Consumers who tried to enroll before March 15 may be eligible for retroactive coverage, and consumers who tried to enroll for the first time after March 15 but by March 31 can enroll after March 31 for coverage starting May 1.12
NevadaAnyone that tried but failed to sign up by March 31, 2014 for health insurance using Nevada Health Link will have another sixty days to complete the process.13
New YorkResidents that say they tried to apply for health insurance by March 31 but were unable to enroll will have until 11:59pm on April 15, 2014 to complete enrollment.14
OregonThe deadline to apply for coverage through Cover Oregon was extended until April 30, 2014. Applications will continue to be processed through May and people will be expected to enroll when they receive an approval form.15
Rhode IslandPeople who were unable to complete their application and select a plan by March 31, 2014 because of system issues may qualify for a special enrollment period.16
VermontOfficials said they would work one-on-one with consumers who were unable to enroll by March 31, 2014.17
WashingtonResidents are eligible to finalize their applications after March 31, 2014 if errors on Washington Healthplanfinder prevent them from enrolling.18
District of ColumbiaPeople that have an online account with DC Health Link who have not yet selected a plan and people that need in- person or telephone help will be able to enroll through April 15, 2014.19

The extended deadlines vary substantially across the state-based marketplaces. Several exchanges extended deadlines from March 31 to April 15, while Nevada extended its deadline sixty days for anyone that tried to sign up by March 31. Massachusetts is giving some people until June 30 to switch to a qualified health plan if they are currently enrolled in a non-ACA-compliant temporary state- run health plan due to application processing delays. Some states such as Maryland and Minnesota will require consumers to call or fill out a form attesting that they tried to complete an application before March 31, while Oregon is simply extending their application period through April 30.

Obamacare Lock Out Period

After the end of the open enrollment period, most consumers lacking health insurance coverage will be locked out of the individual insurance market until the beginning of the next open enrollment period. These consumers will not be able to get effective coverage under a qualified health plan from the individual insurance market until January 1, 2015 at the earliest, but before that time they can still enroll in other kinds of off-exchange insurance such as short-term or large group plans. However short-term insurance plans do not qualify as creditable coverage, so short- term plan enrollees will still face a tax penalty for not being enrolled in a qualified health plan.20

The tax penalty for individuals not enrolled in qualified health plans in 2014 is the greater of 1% of annual household income or $95. If an individual signs up late for a qualified health plan, then their penalty will be reduced by the proportion of time during which they were covered. Furthermore people that are uninsured for less than three months do not have to pay a penalty.21

During the lock out period, consumers in any marketplace can be granted a special enrollment period of sixty days if they have a qualifying life event.22 These events may include:23

  1. Exceptional circumstances (such as natural disasters, medical emergencies, and planned system outages) near the deadline
  2. Marriage
  3. Moving to a new location outside the provider network of their current plan
  4. Birth or adoption
  5. Losing existing health coverage
  6. Misinformation, misrepresentation, or inaction on the part of entities providing formal enrollment assistance
  7. Enrollment errors due to technical issues
  8. System errors related to immigration status
  9. Display errors on marketplace websites
  10. Delays in application transfers for consumers found ineligible for Medicaid or CHIP
  11. Error messages
  12. Unresolved casework
  13. Misinformation about availability of premium tax credits for victims of domestic abuse who are married but not filing a joint tax return
  14. Other system errors

Moreover there is no lock out period for Medicaid or CHIP, so eligible consumers can enroll in these programs at any time.24

Auto-Enrollment & Obamacare Subsidies

If you enrolled in an Obamacare plan through the federal health insurance exchange are automatically enrolled in that same health plan for 2015 plan year25. Any health insurance subsidies you received in 2014 will also be applied to the 2015 plan year26. If you’re interested in switching health plans, you can do so during the Open Enrollment Period starting November 15 to February 15, 2015.



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Sources

1 When can consumers enroll in a plan through Health Insurance Marketplaces? https://questions.cms.gov/faq.php?id=5005&faqId=7381
2 Guidance for Issuers on People “In Line” for the Federally-facilitated Marketplace at the end of the Initial Open Enrollment Period. (March 26, 2014) http://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/in-line-SEP-3-26-2014.pdf
3 Covered California Outlines Application Deadlines for Open Enrollment, Braces for Influx of Enrollees. (March 26, 2014) http://news.coveredca.com
4 Understanding the March 31 Deadline. (March 24, 2014) http://connectforhealthco.com/wp-content/uploads/2014/03/End-of-Open-Enrollment-FAQs2.pdf
5 Amanda Cuda. State relaxes health care deadline -- sort of. (April 1, 2014) http://www.ctpost.com/local/article/State-relaxes-health-care-deadline-sort-of-5364805.php
6 Jenna Blakely. Hawaii Health Connector joins federal exchange in softening March 31 enrollment deadline. (March 26, 2014) http://www.bizjournals.com/pacific/blog/2014/03/hawaii-health-connector-joins-federal-exchange-in.html
7 Jennifer Corbett Dooren. Some Leeway on Health Insurance Coverage Deadline. (March 24, 2014) http://online.wsj.com/news/articles/SB10001424052702303949704579459824199937610?mg=reno64-wsj
8 Report from the Maryland Health Benefit Exchange about Maryland Health Connection, the state-based health insurance marketplace. (March 21, 2014) http://marylandhealthconnection.gov/assets/March21Report1.pdf
9 The 2014 Open Enrollment Period Ends March 31, 2014. Find Out What You Need To Do! (March 21, 2014) https://bettermahealthconnector.org/the-2014-open-enrollment-period-ends-march-31-2014-find-out-what-you-need-to-do/
10 Important update for people who applied for insurance coverage without help paying for costs during open enrollment. (March 26, 2014) https://bettermahealthconnector.org/update-for-people-who-applied-for-insurance-coverage-without-help-paying-for-costs/
11 Jess Bidgood. Massachusetts is Given Extension. (February 13, 2014) http://www.nytimes.com/news/affordable-care-act/2014/02/13/massachusetts-is-given-extension/
12 Frequently Asked Questions. (March 24, 2014) https://www.mnsure.org/images/FAQ-March31-2014.pdf
13 Sandra Chereb. Nevadans blocked by health exchange bugs get another 60 days to sign up. (March 20, 2014) http://archive.rgj.com/article/20140320/NEWS/303200069/Nevadans-blocked-by-health-exchange-bugs-get-another-60-days-sign-up
14 Frequently Asked Questions about the March 31, 2014 Open Enrollment Deadline - For Individuals & Families. http://info.nystateofhealth.ny.gov/sites/default/files/FAQs%20about%20the%20Open%20Enrollment%20Deadline.pdf
15 New Deadline Q & A. http://resources.coveroregon.com/new-deadline-QA.html
16 HealthSource RI Reminds Rhode Islanders of March 31 Enrollment Deadline. (March 28, 2014) http://www.healthsourceri.com/press-releases/healthsource-ri-reminds-rhode-islanders-of-march-31-enrollment-deadline/
17 Vermont Health Connect Open Enrollment Ends March 31. (March 26, 2014) http://info.healthconnect.vermont.gov/sites/hcexchange/files/Press%20Release...March%2031.pdf
18 Washington Healthplanfinder Qualified Health Plan Enrollment Jumps to 125,000. (March 25, 2014) http://www.wahbexchange.org/news-resources/press-room/press-releases/march-25-enrollment-report
19 Responding to High Demand, DC Health Link Continues Enrollment Into Mid- April. (March 26, 2014) https://dchealthlink.com/node/1270
20 Kev Coleman, Jeffrey Smedsrud. 5 Myths about Short-Term Health Insurance. (December 17, 2013) /healthcare-research/infostat/five-myths-about-short-term-health-insurance
21 Kev Coleman, Obamacare Open Enrollment Ends March 31st Despite Public Support for Extension. (March 7, 2014) /healthcare-research/surveys/obamacare-open-enrollment-period
22 Robert Pear. U.S. Announces Further Exemptions for Insurance Enrollment Deadline. (March 26, 2014) http://www.nytimes.com/2014/03/27/us/us-announces-further-exemptions-for-insurance-enrollment-deadline.html
23 Guidance for Issuers on Special Enrollment Periods for Complex Cases in the Federally-facilitated Marketplace after the Initial Open Enrollment Period. (March 26, 2014) http://www.cms.gov/CCIIO/Resources/Regulations-and- Guidance/Downloads/complex-cases-SEP-3-26-2014.pdf
24 How can I get coverage outside of open enrollment? https://www.healthcare.gov/how-can-i-get-coverage-outside-of-open-enrollment/
25 http://www.cnbc.com/id/101793283#
26 http://www.gpo.gov/fdsys/pkg/FR-2012-03-27/pdf/2012-6125.pdf

 

 

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