Health Care Open Enrollment

Feb 23, 2016

  1. JimmyUt
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    JimmyUt Guru

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    Does the open enrollment period apply to all individual health insurance or just marketplace plans? I assume it is all plans and unless they have an SEP they are stuck? Am I right?
     
    JimmyUt, Feb 23, 2016
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  2. timamr
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    The "open enrollment period" applies to the ACA, aka Obamacare. There is special enrollment where if u lost coverage, got married, death in family, etc that can qualify you for a special enrollment.

    There is also short term medical plans and also plans that are not ACA approved that you can buy at any time.
     
    timamr, Feb 23, 2016
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  3. JimmyUt
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    So in order to get a compliant plan and not be fined whether on or off exchange you are limited to open enrollment
     
    JimmyUt, Feb 23, 2016
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  4. timamr
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    yep, that is my understanding
     
    timamr, Feb 24, 2016
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  5. bluediamond
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    Yes, you are correct. The only way is to have a qualifying event.
     
  6. AgentStone
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    Unfortunately, OE is closed for all on/off Mktpl plans... Only option SEP
    Getting 2016 coverage with a Special Enrollment Period https://www.healthcare.gov/coverage-outside-open-enrollment/special-enrollment-period/

    I had a client email today disgruntled over the provider selection with her IMM plan. She had the same question...Am I stuck? :err: They own a business, so as an option, I can suggest a group plan with a better provider selection.
     
  7. DS4
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    "Yes & No".
    Open enrollment ended 1.31.16.
    Last week, I had a person call me about getting health insurance. I told them open enrollment ended. Without a "life event", they cant apply for MEC until next fall. No life event for them
    They called the state exch. They got a 3.01.16 effective dates.
    I asked how they were able to enroll outside the open enrollment?? They didn't know. The person at the state exch "took care of it".
    I guess there is one set of rules for us nasty agents, and, another set of rules for state exch ee's.
    Or, there is a double secret "life Event" code I'm not aware of??
     
    DS4, Feb 29, 2016
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  8. AgentStone
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    I had a prospect call in Nov for a 12-1-15 eff date w/o life event. She said she was having surgery in Dec. I told her she'd have to wait until 1-1 to get MEC ins. She called HC.gov and they got her covered for 12-1. :skeptical: There must be a special BS code only used by navigators that we weren't apprised of in our training!!
     
  9. russelltw
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    This happened to me 5 times last year. No QLE to trigger the SEP, but I referred each to HC.gov and all of them said they were able to get coverage starting the next month.

    Sadly, a client can call the first time and get "educated" on what to say the second time also.

    Monday, I had a client call who switched plans on 1/25/16 for a 3/1 date. He called the HC.gov and asked some questions. THe rep went on about how the client needed to reset his password, then was suddenly disconnected. Turns out, the 3/1 plan has been cancelled and now client is SOL. Trying to get HC.gov to re-instate, but they are slow to do it. I am thinking new rep accidentally cancelled the plan then hung up.

    We have a set of rules, HC.gov doesn't have any set of rules...
     
  10. TN_agent
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    Turner, you may want to tell the government that.

    Almost all of us have stories about clients without a valid SEP based on what they are telling us who miraculously are somehow enrolled at hc.gov when they call in.
     
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