Open Enrollment Period Frequently Asked Questions

  • Originally published November 19, 2014 , last updated November 6, 2018
Open Enrollment Period Frequently Asked Questions

Open Enrollment Period Frequently Asked Questions

During the open enrollment that started Saturday, Nov. 15, 2014, and ends Feb. 15, 2015, individuals and families can purchase their ACA-compliant major medical plans for coverage that starts in 2015. For many people, this year’s open enrollment period is the only chance they’ll have to purchase ACA-compliant major medical coverage for the 2015 calendar year. To get more details and get contracted, call the Senior Market Sales Major Med Department at 1-877-888-9980.

To help you prepare for ACA, here are answers to five frequently asked questions about the ACA and open enrollment.

Q. Can I purchase a plan outside of open enrollment?

A. Yes, for those with a qualifying life event, plans may be purchased outside of open enrollment. Examples of qualifying life events that allow for purchase outside of OEP, during a 60-day special enrollment period, are:

  • Your health insurance plan is changing to include the new benefits required under health care reform in 2014.
  • Your current health plan is being renewed.
  • You lose employer-sponsored or government-sponsored health insurance that is Minimum Essential Coverage.
  • You lose health insurance with Minimum Essential Coverage due to a divorce, job loss, or death of a spouse or parent.
  • You’ve had or expect to have a major life change (marriage, birth of a child, etc.)
  • Additional life events

Q. What does “ACA-compliant” mean?

A. Among many other distinctions, it defines a plan as Minimum Essential Coverage, which means the plan complies with the reform law and covers medical services and products that may not have been covered prior to reform, like preventive care, medical services related to pre-existing conditions and more.

Q. When will my coverage start?

A. If you purchase between Nov. 15 and Dec. 15, 2014, your coverage can start as early as Jan. 1, 2015. If you purchase between Dec. 16, 2014, and Jan. 15, 2015, your coverage can start as early as Feb. 1, 2015. And if you purchase between Jan. 16 and Feb. 15, 2015, your coverage can start as early as March 1, 2015.

Major medical coverage usually starts at least 15 days or more from the date the plan was purchased. It’s important to be aware of the date your coverage will start, especially if you want to purchase a major medical plan with coverage that begins on a specific date.

Keep in mind that for many individuals and families, ACA-compliant major medical plans will not be available for purchase again until the open enrollment period for 2016.

Q. Am I eligible for financial assistance?

A. Certain consumers may be eligible for financial assistance when they purchase a marketplace plan during open enrollment. Typically, subsidy eligibility is calculated by the level of household income, as well as the price of certain plans available in their state.

The most well-known type of subsidy available is the advanced premium tax credit. Also known as a premium subsidy, this is a tax credit you can use right away to help reduce the cost of ACA-compliant major medical plans. Depending on your situation, there may be other forms of subsidies available.

Q. I already have an ACA plan. What should I do?

A. Most health insurance plans purchased through HealthCare.gov will renew automatically. You’ll want to keep an eye on the mail to make sure you don’t miss communication from your health insurance company. This is especially important because there could be changes to your existing plan that cause you to want to change plan categories or even providers. Current Marketplace plans expire December 31, 2014. Coverage purchased during the last open enrollment period will end on December 31, 2014. Many Americans who enrolled in coverage through HealthCare.gov will be automatically re-enrolled in that coverage, and any associated tax credits, for 2015. However, the rules differ for many state-run Marketplaces. Check with your Marketplace to determine what actions, if any, are necessary to ensure your coverage continues.

To get contracted, to get a quote, or to get other questions answered, call Senior Market Sales Major Med Department to talk to a dedicated Marketer to learn more about what you need to do to be successful this OEP by calling 1-877-888-9980.

Request a contract.