So This info actually comes from a loophole taught to me by a market place supervisor.
In the event a client is outside of the annual open enrollment period, and is unable to qualify for a special enrollment period, that said client can be enrolled into a temporary insurance plan.
now the tricky part :
to avoid the tax penalty while on said temporary plan, the client must chose a plan that has the 10 essential core benefits required by law. they can be obtained on a temporary plan by way of riders offered by the insurance carrier.
how can they stay with in their affordability comfort zone?
easy temporary policies have low premiums in general making them affordable to the client, and for a small fee they can have dental and vision plans added on to them and still remain cheaper than most market place plans and give them a little more beneficial value due to the added benefits of having dental and vision.
what if they get the temporary policy and it is missing an essential benefit?
In these cases unfortunately they will be penalized, but at least they had coverage when they needed. so in this case for the client it is win lose unless they add on the riders needed to make the plan have minimum essential coverage.
how long are temporary policies?
they vary depending upon the carrier. some are 1 month, 6 months, 11 months, and 12 months.
how does this help my client?
In the long run they wont have a lapse in coverage and they can use this loophole to buy them time until the do have a life changing event that qualifies
them for an sep. Then they also have the option to use it until the annual enrollment period opens up and they can then chose a marketplace plan.
so just to recap:
you can enroll a client into a temporary healthcare plan outside of oep and sep, so long as it has all the core benefits they will not be subject to the tax penalty.
this should be a temporary last resort if there are no other options available to the client.
In the event a client is outside of the annual open enrollment period, and is unable to qualify for a special enrollment period, that said client can be enrolled into a temporary insurance plan.
now the tricky part :
to avoid the tax penalty while on said temporary plan, the client must chose a plan that has the 10 essential core benefits required by law. they can be obtained on a temporary plan by way of riders offered by the insurance carrier.
how can they stay with in their affordability comfort zone?
easy temporary policies have low premiums in general making them affordable to the client, and for a small fee they can have dental and vision plans added on to them and still remain cheaper than most market place plans and give them a little more beneficial value due to the added benefits of having dental and vision.
what if they get the temporary policy and it is missing an essential benefit?
In these cases unfortunately they will be penalized, but at least they had coverage when they needed. so in this case for the client it is win lose unless they add on the riders needed to make the plan have minimum essential coverage.
how long are temporary policies?
they vary depending upon the carrier. some are 1 month, 6 months, 11 months, and 12 months.
how does this help my client?
In the long run they wont have a lapse in coverage and they can use this loophole to buy them time until the do have a life changing event that qualifies
them for an sep. Then they also have the option to use it until the annual enrollment period opens up and they can then chose a marketplace plan.
so just to recap:
you can enroll a client into a temporary healthcare plan outside of oep and sep, so long as it has all the core benefits they will not be subject to the tax penalty.
this should be a temporary last resort if there are no other options available to the client.
