Open Enrollment Period
The open enrollment period for the 2016 plan year begins November 1, 2015 and ends January 31, 2016.
The open enrollment period for the previous 2015 plan year began on November 15th 2014 and ended on February 15th 2015. The Department of Health and Human Services (HHS) announced a special enrollment period for those people who are in states that use the Fed exchange and face an ‘unisured’ tax penalty for 2014. Those eligible for this special enrollment period must live in states with a Federally-facilitated Marketplace and meet three conditions:
- Currently are not enrolled in coverage for 2015
- Attest that when they filed their 2014 tax return they paid the fee for not having health coverage, and
- Attest that they first became aware of the uninsured penalty in connection with preparing their 2014 taxes
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:
Other states that run their own exchanges, such as California, are offering similar Special Enrollment Periods in 2015 for people who face an uninsured penalty on their 2014 taxes. People experiencing life events that change their circumstances during the year, such as childbirth or job loss, should review our special enrollment period article.
- 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.
|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, Wyoming||Consumers 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|
|California||Individuals 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|
|Colorado||Connect 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|
|Connecticut||The 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|
|Hawaii||The 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|
|Kentucky||Residents have until April 15, 2014 to select a plan if they submitted an application for coverage on or before March 31.7|
|Maryland||Anyone 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|
|Massachusetts||People 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|
|Minnesota||People 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|
|Nevada||Anyone 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 York||Residents 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|
|Oregon||The 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 Island||People 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|
|Vermont||Officials said they would work one-on-one with consumers who were unable to enroll by March 31, 2014.17|
|Washington||Residents are eligible to finalize their applications after March 31, 2014 if errors on Washington Healthplanfinder prevent them from enrolling.18|
|District of Columbia||People 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, 2016 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 2% of annual household income or $325 per adult. See our tax penalty article for more information. 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
- Exceptional circumstances (such as natural disasters, medical emergencies, and planned system outages) near the deadline
- Moving to a new location outside the provider network of their current plan
- Birth or adoption
- Losing existing health coverage
- Misinformation, misrepresentation, or inaction on the part of entities providing formal enrollment assistance
- Enrollment errors due to technical issues
- System errors related to immigration status
- Display errors on marketplace websites
- Delays in application transfers for consumers found ineligible for Medicaid or CHIP
- Error messages
- Unresolved casework
- Misinformation about availability of premium tax credits for victims of domestic abuse who are married but not filing a joint tax return
- 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 2016 plan year25. Any health insurance subsidies you received in 2015 will also be applied to the 2016 plan year26. If you’re interested in switching health plans, you can do so during the Open Enrollment Period starting November 1, 2015 to January 31, 2016.