When the Affordable Care Act started, health insurance enrollment was limited to a three month cycle each year. For 2016 open enrollment is November 1st, 2015- January 31st, 2016, with the first date of coverage able to start on January 1st, 2016. Any enrollment outside of that time has to be triggered by a qualifying event (QE). Although, many Americans find themselves in a rock in a hard place as they are outside of employment and believe that they can get coverage when they start their new job. Unfortunately a new job is not considered a qualifying event.
As a Colorado health insurance broker, I will explain why we now have open enrollment. Before the ACA individuals were dependent on medical underwriting for health insurance. The insurance carrier decided if the individual was qualified to purchase health insurance, and had the possibility of being denied coverage. After the passing of the ACA all policies are considered guaranteed issue, meaning that nobody has to qualify to have health insurance. If you are a living and breathing individual you now qualify. This puts a greater risk on health insurance companies as they are now insuring individuals with no prior knowledge of their health status. Open enrollment protects the health insurance companies to instill confidence that an individual will not enroll in a policy then drop their policy as soon as they have completed their medical needs. Thus creating a need for a Special Enrollment Period (SEP) for life events outside of the three month cycle.
When I think of a QE I think of anything life changing like a move, marriage, baby, and a NEW JOB, but the ACA does not consider having a new job as a qualifying event. A QE gives an individual a sixty day SEP to enroll in a new plan or change their current plan. If you have ever had employee sponsored group insurance then you should be familiar with this type of enrollment, but those that haven’t could be caught off guard.
As you go into 2016 the best way to make sure you and your family are covered is to enroll within open enrollment dates. This way you can see if you are eligible for a subsidy (tax credit) to help with the cost of your health insurance and ensure that you and your family are covered. This will also remove doubt that the ” qualifying=”” event”=”” that=”” you=”” were=”” relying=”” on=”” to=”” make=”” changes=”” coverage=”” or=”” obtain=”” new=”” from=”” is=”” not=”” truly=”” a=”” qe.<=”” p=””>