What is Special Enrollment?

Special Enrollment is a window of time outside of the annual open enrollment period during which you and your family can enroll in a healthcare plan. The next annual open enrollment period for the 2016 plan year is currently scheduled for November 1, 2015 – January 31, 2016.

Eligibility for Special Enrollment is limited to those with a qualifying event, such as a change in family status, a move, or the loss of group health insurance. These and other qualifying events allow people to enroll in a  health insurance plan outside of the normal annual open enrollment period. It’s important to note that most special enrollment periods last 60 days from the date of the qualifying event and require proof of the change. If coverage is not obtained during this period, then the next opportunity to enroll would be during the annual open enrollment period.  Note: Medi-Cal is available all year, and no qualifying life event or special enrollment period is required to enroll in Medi-Cal.

If you are interested in changing plans and think you may qualify for a special enrollment or aren’t sure, give us a call. We’ll be happy to answer you questions and advise you.

Phil Dougherty
OnlyHealthInsurance

A Case of the Flu.

2015 started with a bang…actually with a cough.  Like many in my circle of friends and acquaintances, I got the flu.  After a few days of suffering, I found myself on a Saturday morning in mid-January with a choice to make. Do I continue with my Nyquil binge and wait till Monday to see my doctor or head out now to visit an Urgent Care center?   Continue reading

Blue Shield and Sutter Health, a love story.

It was touch and go there for a bit, but Blue Shield of California and Sutter Health resolved their differences and signed a new two-year agreement that will keep Sutter hospitals and medical centers in Blue Shield’s provider network.  The public jousting was palpable and thankfully short-lived.  Coming to an agreement before the end of the open enrollment (February 15) means many can check insurance off their to-do list, for a while anyway. Continue reading

Deadline approaching…

There are just five days left to renew your health insurance for 2015 if you want it effective on January 1, 2015. 

In both Covered CA and the private marketplace, you have through December 15, 2014 to explore your options and make any changes to your health insurance for a January 1, 2015 effective date. Please read the specifics below to understand your options based on the market in which you obtained your current health insurance. Continue reading

Open Enrollment is here!

The first annual open enrollment period since the implementation of health care reform has started and it’s time to evaluate plan options for 2015.  For those who have existing individual or family coverage and want to consider a change, are enrolled in group or COBRA insurance and want to compare their current plan with 2015 marketplace plans, or are without health insurance and entering the market for the first time, now is the time to consider a change. Continue reading

Commissioner Jones: Superhero or Opportunist?

BAM! POW! WHAM! Insurance Companies take cover. CA Insurance Commissioner Dave Jones has changed into his spandex and cape! (Play superhero theme music.)  And, with the help of his sidekick (Proposition 45), he’s ready to challenge his arch nemesis (aka insurance companies) and protect the good people of Gotham (California) from their tentacles and stinging rate increases. (Aside: Isn’t anyone concerned that there are no more phone booths for Superman to change in?) Continue reading

It’s not just what’s on the ballot that matters; it’s when the vote is held.

There is no better example of this than the upcoming November election.

Originally set for October 15 – December 7, this year’s annual open enrollment period, when consumers can enroll in ACA compliant coverage for the first time or change plans for the next plan year, was pushed out to November 15 – February 15.  CoveredCA, California’s version of ObamaCare, has followed suit and will match the new open enrollment schedule.

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How to Choose a Carrier.

Health Care Reform has leveled the playing field as far as coverage benefits and eligibility goes. Plans are standardized and fall into four distinct benefit levels (Bronze, Silver, Gold, and Platinum) and must be actuarially equivalent. Pre- existing conditions no longer restrict your access to coverage or result in higher premiums. By removing these two critical elements, what’s left to compare? Plenty!

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Next Open Enrollment Period Uncorked…

In addition to sizing up a turkey or sniffing a yam, you might add squeezing a health plan or two into your Thanksgiving shopping list. This year’s open enrollment period was moved from October 15 – December 7 to November 15 – February 15, 2015, and if you want to ring in the New Year with a “fresh” plan, you’ll have a shorter amount of time to act this year.  Let’s look a little closer to see what this enrollment period date change really means. Continue reading

Employers & Employees Beware.

Popular among small employers was an arrangement by which they would pay the employee’s individual insurance plan premiums on a pre-tax basis. Market reforms within our new healthcare law now prohibit this.

Starting January 1, 2014, employers who reimburse or pay premiums directly to a carrier for any employee’s individual or family health insurance policy will no longer be able to do so tax-free. This may adversely affect both employer and employee. Continue reading