All About The Open Enrollment Period for HealthCare.gov
Dan Levenson February 09, 2016
The open enrollment period for HealthCare.gov is the yearly period when anyone can enroll in a health care plan through the Affordable Care Act (ACA). It’s designed to help people get insured if they happened to miss getting insurance during the regular enrollment period.
On a general basis, this enrollment period occurs at the beginning of the year after the initial enrollment time frame occurs. However, HealthCare.org gives some other options under special circumstances. If you don’t offer a group health insurance plan, this can help your employees who may have missed the initial deadline to enroll for 2016.
Thanks to ACA rules, you or your employees could still enroll throughout the year based on certain life events. In an unpredictable world, you never know when one of your employees may suddenly need insurance if they didn’t have it before now.
If you have a small business, it’s possible you let your employees obtain their own insurance. Or, you may reimburse their premiums through a health care reimbursement plan.
Whatever the situation, it’s worth knowing more details about open enrollment and the special cases available to protect against risk.
Open Enrollment for This Year
The beginning of open enrollment for 2016 plans began last November 1. That initial period ended on December 17, though the month of January provided another opportunity to sign up. This last January 15, an extension lasted until January 31 to get coverage for the new year.
Late January was the last chance for those who aren’t qualified for a special enrollment period. Fortunately, it doesn’t knock everyone out of contention.
In the above arrangement, you or an employee could still get insured during any month. Take a look and see if your staff can take part in the special enrollment period, plus the rules applied toward businesses.
Understanding Special Enrollment
Since your employees could face penalties for not obtaining insurance this year, they may still get coverage, depending on life circumstances. These life changes don’t necessarily have to involve something unfortunate like major health events.
If an employee is about to get married or about to give birth to a child, this can entitle them to take part in special enrollment. Or, if your employee suddenly loses health insurance due to being unable to pay premiums, they can quickly recover with this enrollment offer.
For normal households, a person has to wait 60 days after the above life events occur. In a job-based plan, it’s a requirement to give 30 days for employees. Any of your staff could quickly get covered within a month if they happened to lose their health insurance policy 30 days before.
How to Sign Up for Special Enrollment
Just like an employee would during open enrollment, signing up simply involves going to HealthCare.gov. They make it easy to start a marketplace account in a matter of minutes. Even if someone already has an account, it’s kept active with a password.
The site takes a user through simplified steps to make sure they’re completely qualified for a specialized enrollment option. After signing up, the site lets an employee know exactly when coverage starts. ACA rules provide a new option for expectant mothers where coverage can begin the day the child is born.
Medicaid and CHIP Programs for Qualified Employees
As a variation on open and special enrollment, those with overly low incomes, pregnant women, and those with disabilities can qualify for Medicaid. This usually goes with the Children’s Health Insurance Program (CHIP), which is useful if an employee wants to buy coverage for their children. When an employee uses these programs, they can get coverage the day they sign up.
Of course, when you provide health insurance benefits to your employees through a group plan, no one has to worry about enrollment periods for the health care marketplace. But if you either can’t afford to offer such benefits or simply don’t have enough employees to justify the cost, the information above can help you and your employees find suitable options while avoiding penalties.