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INDIVIDUAL / FAMILY GROUP MEDICARE OBAMACARE

Open Enrollment Has Started!

Marketplace Enrollment November 1, 2016 through January 31, 2017

If you enroll now through December 15, your effective date is January 1, 2017.

If you enroll from December 16 through January 15, your effective date is February 1, 2017.

If you enroll from January 16 through January 31, your effective date is March 1, 2017.

 

Remember, the only way to change plans or enroll after Jan. 31, 2017 until next year’s open enrollment, Nov. 1, 2017, is if you have a QUALIFYING EVENT. See the list of qualifying events below.

 

The Affordable Care Act Individual Mandate tax penalty applies for you, your spouse, or your tax dependents if you do not have qualifying health coverage during the year.  In some, cases you may qualify for a health coverage exemption from the requirement to have insurance. If you qualify, you won’t have to pay the fee.

 

The fee for not having health insurance is 2016 and beyond is 2.5% of household income or $695 per adult/$347.50 per child under 18, whichever is greater.

 

You can still apply for coverage if you’ve had one or more of these life events occur in the last 60 days, you can still apply for insurance through the special enrollment period.

Qualifying events in the last 60 days are:

  • I and/or my dependent(s) lost minimum essential coverage
  • Involuntary loss due to reasons other than non-payment of premium or recession
  • Due to reaching the maximum age, legal separation, divorce, or death of the policyholder
  • I am no longer eligible for my prior health insurance plan due to termination of employment, reduction in number of hours of employment, loss of employer contribution toward my premium, or I have exhausted my COBRA benefits
  • I am no longer residing or living in my prior health insurance plan’s HMO service area
  • I have a claim that would meet or exceed a lifetime limit on all benefits
  • I have lost coverage because my plan no longer offers benefits to the class of similarly situated individuals
  • I have lost coverage through my group HMO because I no longer reside or work in the service area and no other package is available
  • I gained or became a dependent due to marriage
  • I gained or became a dependent due to birth, adoption, or placement for adoption or foster care
  • An error occurred in my previous health plan enrollment on, or I have adequately demonstrated that my previous health plan or issuer substantially violated a material provision of its contract with me
  • The Health Insurance Marketplace has determined that I or my dependents are newly eligible or ineligible for payments of the advance premium tax credit, or have a change in cost-sharing eligibility, or misconduct by a non-marketplace entity
  • I gained access to new health plan options because of a permanent move
  • My current policy is ending in a non-calendar year

If none of these events have occurred, you can still get coverage sooner by shopping for a Short-Term Health Insurance Plan

For people already enrolled in Marketplace coverage: Having a change in income or household status that affects eligibility for premium tax credits or cost-sharing reductions. Please call Marketplace at 800.318.2596. This is a 24 hour phone number.