5 key changes for the Obamacare enrollment season
In November, health care reform rolls into its second annual open enrollment period — and some key things are changing for consumers hoping to buy a health insurance plan on the federal and state exchanges.
Estimates vary, but the White House said in April that 8 million people purchased a plan through the exchanges in the 2013-14 enrollment period.
Now, a few big changes have arrived in time for 2014-15, including a shorter enrollment period and bigger penalties for those who fail to purchase health insurance coverage.
Following are five changes to the open enrollment period for health insurance coverage in 2015.
1. Open enrollment will be shorter.
During this year’s open enrollment, you’ll have just three months to purchase a health insurance plan on the federal and state exchanges — from Nov. 15 to Feb. 15 of next year.
Last year, Americans had five months to sign up for a health care policy.
Want to find out if you qualify for a subsidy? Use our Obamacare subsidy calculator to see if you qualify for a financial break and be routed to the right place to buy insurance.
Because of the newly shortened time frame, it’s important not to procrastinate, says Robin Gelburd, president of FAIR Health, a nonprofit that provides information about health insurance and health care costs.
Signing up early will make sure you’re processed through the insurer’s system in time to have coverage in force by Jan. 1. That way, there will be no dispute if you have to access care early in 2015.
If you fail to meet next year’s Feb. 15 deadline, you won’t be able to buy a policy on the federal and state exchanges unless you experience a qualifying life event, such as moving to a new state, losing your job, or getting married or divorced.
2. Financial penalties will increase.
If you fail to purchase health insurance, you’ll still be subject to pay a financial penalty. In addition, the cost will be higher in 2015 than it was in 2014.
In 2014, the penalty was 1 percent of a person’s income, or $95 per adult and $47.50 per child, whichever was highest.
In 2015, the penalty increases to whichever of the following is highest:
- 2 percent of your income.
- $325 for an uncovered adult.
- $162.50 for an uncovered child.
Some individuals may be exempt from paying the penalty. You can find out more about these exemptions at the HealthCare.gov website.
According to Jim Duffett, a health care consumer consultant based in Chapel Hill, N.C., the more significant penalties in 2015 and beyond should motivate consumers to get coverage.
3. More employers now must offer coverage.
Beginning in 2015, employers with 100 or more employees must offer health insurance to at least 70 percent of their full-time employees.
As a result of this change, people who bought a plan on the exchanges last enrollment season may be eligible to get coverage through their workplace this year.
If you work for a company with at least 100 employees but are unsure about your status, ask your human resources department if you’ll be eligible for employer-based coverage.
Duffett says many people who get coverage through their workplace will likely pay less and have more medical provider options than they did in the plan they purchased last year on a federal or state exchange.
For example, many health plans purchased on federal and state exchanges tend to restrict the selection of medical providers, especially when compared to networks associated with group plans.
This rule will change again in 2016 when businesses with 50 or more employees will have to offer coverage to 95 percent of employees.
4. Health coverage now automatically renews.
This summer, the federal government announced that people who purchased health insurance on the federal exchange for 2014 would have their policies automatically renewed for 2015.
Some states that run their own exchanges are expected to follow suit.
“Automatic renewals are very important in ensuring that no one is left in a situation where they unintentionally lose their coverage because they forgot to renew,” says Jillian Phillips, Chicagoland organizer for the Illinois-based Campaign for Better Health Care.
However, renewals may have an unexpected downside for some policyholders who receive federal subsidies to make their coverage more affordable.
A recent study by Avalere Health found that many people in this group will end up paying much more for their coverage in 2015 if they simply stick with the same plan they had in 2014 because the federal government is making changes to the way it’s calculating subsidies. You can find out more here.
Phillips says that consumers should always compare plans in order to choose health coverage that best fits their needs.
5. Coverage dates are tweaked slightly.
Last year, you could purchase coverage as late as Dec. 23, and it would still go into effect by Jan. 1.
However, this year, you’ll have to purchase coverage by Dec. 15 to ensure it begins on the first day of 2015.
Anyone who buys insurance between Dec. 16 and Dec. 31 will have to wait until Feb. 1, 2015, before coverage becomes effective.
During the rest of the enrollment period, anyone who purchases coverage between the first and 15th days of the month will see their health insurance policy kick in on the first of the following month.
However, if you purchase insurance between the 16th day and the last day of the month, coverage won’t begin until the first day of the second following month.
If you’re intimated by the prospect of choosing a plan, don’t let it delay you from getting coverage. Phillips suggests contacting a certified navigator, broker or agent who can help you sort through your options.
