Written by Carrie Johnson (former SDSU Extension Family Resource Management Specialist).
On Sunday, November 1st, you can enroll in a Qualified Health Plan in the Marketplace during the Open Enrollment Period. The enrollment will go until January 31, 2016. These dates are significantly different from the previous open enrollment. Remember, if you have an employer-sponsored health plan and it is “affordable” (not greater than 9.5% of your household income), you are eligible to purchase a plan in the Marketplace, but not eligible for any premium tax credits.
If you haven’t enrolled by January 31st, you will not be able to purchase a plan through the Marketplace until the next year’s enrollment period unless you are eligible for a Special Enrollment Period. You may receive a Special Enrollment Period if you have had a qualifying life event:
- Marriage or divorce
- Having a baby, adopting a child, or placing a child for adoption or foster care
- Moving your residence, gaining citizenship, leaving incarceration
- Losing other health coverage due to losing job-based coverage, the end of an individual policy plan year in 2015, COBRA expiration, aging off a parent’s plan, losing eligibility for Medicaid or CHIP, and similar circumstances (voluntarily ending coverage does not qualify)
- 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
- Gaining status as member of a federally recognized tribe or shareholder in an Alaska Native Claims Settlement Act (ANCSA) Corporation (members of federally recognized Indian tribes can enroll in or change plans once a month throughout the year
Continuing Your Coverage
If you enrolled during the 2015 period your coverage will end on December 31, 2015. To continue coverage in 2016, you can renew your current health plan or choose a new one. If you had a plan in 2015, your insurance company may automatically enroll you for 2016 but they will need to notify you of this. If you do not have health insurance during 2016, you may have to pay a fee of 2.5% of you income OR $695/adult and $347.50/child; whichever is higher.
Important Dates for 2016 Open Enrollment
- Between November 1st and December 15th: your coverage starts January 1, 2016
- After December 15th before January 15: your coverage starts February 1, 2016
- After January 15th: your coverage starts March 1, 2016
For more questions regarding the Affordable Care Act and how it may affect you visit healthcare.gov.