Open Enrollment 2016 and 2017
posted April 6, 2016
Open Enrollment has ended for 2016. You can no longer apply for coverage or make changes to your current plan unless you have a Qualifying Event that makes you eligible for a Special Enrollment Period (SEP). Qualifying Events include the following:
- Loss of minimum essential coverage for one of the following
- Involuntary loss due to reasons other than nonpayment of premium
- Due to reaching the maximum age (26), legal separation, divorce or death of the policyholder
- No longer eligible for prior health coverage due to termination of employment, reduction of hours of employment or exhaustion of COBRA benefits
- No longer residing in prior health insurance plan's HMO service area
- Gained or became a dependent due to marriage
- Gained or became a dependent due to birth, adoption or placement for adoption or foster care
- Current policy is ending in a non-calendar year
- Becoming a citizen
- Leaving incarceration
- AmeriCorps's members starting or ending service
- Changes in your income that affect coverage you qualify for
- Other qualifying event
In 2016 the penalty for not purchasing health insurance will be calculated one of two ways - either per person or as a percentage of income. You'll pay whichever is higher. If it is calculated per person it will be $695 per adult and $347.50 per child with a maximum of $2,085 per family. It may also be calculated by percentage and in 2016 it is 2.5% of household income to a maximum of the average cost of a bronze plan on the Marketplace.
OPEN ENROLLMENT for 2017 will begin November 1, 2016 and end January 31, 2017. Open Enrollment for 2016 proved to be extremely challenging due to the change in networks for many consumers. This past year Blue Cross took away their large PPO network from individual policyholders and many insureds needed to find a new carrier to remain with their providers. Plans changed, providers changed and premiums increased so we at PIP urge you to begin early so you have time to make an informed decision for 2017.
NOTE REGARDING TEMPORARY HEALTH INSURANCE: IF YOU DO NEED COVERAGE AND DO NOT HAVE A QUALIFYING EVENT YOU CAN PURCHASE TEMPORARY HEALTH INSURANCE. Since temporary coverage is not compliant with the Affordable Care Act (ACA) you may still pay a penalty when you file your income taxes. However, it will provide you with coverage in the event you have a catastrophic health issue in 2016.
HSA Newsletter Updated
posted April 5, 2016
Open Enrollment 2016
posted September 7, 2015
We are quickly approaching the third Open Enrollment for the Affordable Care Act (ACA). Open Enrollment will begin November 1st, 2015 and ends January 31st, 2016. For your new coverage to be effective January 1st, 2016, your application must be submitted no later than December 15th, 2015. Applications received December 16th and beyond will have later effective dates (for example an application received after December 15th but on or before January 15th would be effective February 1st). If you want to change your current plan or you want to switch carriers this is when you are allowed to do so. All the agents at Professional Insurance Producers are experienced and knowledgeable regarding health insurance plans both on and off the Marketplace.
If you now have a premium tax credit through the Marketplace (the Exchange) that reduces the cost you are paying for your insurance you are required to "redetermine" your eligibility. You need to call 800-318-2596. They will review your anticipated income for 2016 and determine your tax credit for the upcoming year. Keep in mind that anytime you have life changes you should contact the Marketplace (the Exchange) and let them know. Life changes include changes of income, change of address, marriage or divorce, and birth of a child.
Please refer to the chart below to see if you may be eligible for a premium tax credit.
|Family Size||Yearly Income|
If you do not qualify for a premium tax credit, there is no reason to shop on the exchange. In fact, it is advantageous for you to shop off the exchange as there are more carrier and plan choices off exchange. When you purchase on exchange you have to make all your changes through the exchange which complicates the process.
Whether you shop on or off the exchange, please call us at (847) 297-5511 to facilitate the process and explore your options.