Important Information for Open Enrollment - Exact Insure
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Important Information for Open Enrollment

It’s that time of year again. Open Enrollment for Affordable Care Act health insurance plans begins November 1, 2015 and ends January 31, 2016.

This article provides information for those who do not currently have insurance, those who are on an Affordable Care Act plan, and those who are on Grandfathered plans.

If You Do Not Currently Have Health Insurance

The penalty for failure to carry health insurance will increase, from 2% in 2015 to 2.5% in 2016, or a flat penalty of $695 per adult and $347.50 per child, whichever is greater. The percentage is applied to the portion of a person or family’s income that is above the tax filing threshold, which is about $10,150. So, a family making $60,000 per year will be penalized on about $49,850, making their penalty about $1246. The maximum penalty is the national average for a Bronze Affordable Care Act Plan, which was $2448 in 2014. This is often much more than a person or family would have paid to maintain health insurance.

If you do not currently have health insurance, an experienced insurance agent can help you navigate this difficult process, at no cost to you. If you are an Indiana or Kentucky resident, call us at 317-686-5767 for assistance.

If you have an ACA (Affordable Care Act) plan:

All 2015 ACA plans will end on December 31, 2016, regardless of when the plan was instated. As long as you are current on your health plan payments, you will be automatically re-enrolled in the same plan, if that plan is still available. If that plan is no longer available, your insurance company will enroll you in a similar plan. Either way, you will receive notification from your insurance company with the plan information.

However, we strongly advise you to take an active roll in your 2016 enrollment, for several reasons:

  • Your rates may go up, even if your plan remains the same, but your subsidy will not be increased automatically. Or, worse, your subsidy might be removed entirely. 
  • The network of doctors covered under your plan may change, and your preferred provider may no longer be covered under that plan.
  • As health plans are changing in 2016, you may benefit from changing your plan.
  • Finally, the ACA requires that you update your household and income information on an annual basis.

healthcare-paperworkIt’s important to note that, in order for the changes to your plan to go into effect January 1 – including keeping or updating your subsidy – you must complete those changes by December 15. If you miss the December 15 deadline, but complete them by January 15, the changed coverage will go into effect on February 1. If you miss that deadline but complete them by January 31, your changes will go into effect March 1. If you do not make changes before January 31, you will be ineligible to make changes for 2016, unless you experience a major change in circumstances, such as having a baby or adopting a child, moving, job loss, marriage or divorce.

While you can navigate this process directly with your insurance provider, or via www.healthcare.gov, we highly recommend that you work with a trusted insurance agent to help guide you through these confusing and murky waters. An experienced agent will be familiar with all plan options available to you, and can help save you a lot of the headaches that can come along with going it alone. An agent provides their services at no cost to you. The price of your health care plan remains the same, but you will enjoy a much higher level of service than attempting to deal with the large call centers of the government or insurance company.

Indiana and Kentucky residents can contact Exact Insure and take advantage of our experience and knowledge as they enroll for their 2016 health care coverage. Call us at 317-686-5767, and we will respond quickly to provide you with the information you need to make the best possible selection for you and your family.

If you have a grandfathered, non-ACA plan:

Grandfathered plans are those that were purchased before March 23, 2010, and have remained unchanged in the intervening years.  There are relatively few individuals who are still on grandfathered plans.  Grandfathered plans do not have to abide by the rules and regulations of the ACA, and therefore are generally less expensive.

Unfortunately, many of those individuals who still have grandfathered plans will have to move into ACA plans in 2016. While the White House has said that grandfathered plans can be extended to 2017, some states are not allowing grandfathered plans to continue in 2016. This is not the case for Indiana and Kentucky, where Exact Insure is licensed. However, due to the cost of attempting to provide customer service for grandfathered plans, many insurance companies, including Anthem, are transitioning their grandfathered plans to ACA-compliant plans.

Thus, while there are a few individuals who will be able to maintain their grandfathered plans in 2016, chances are good that yours will be transitioned to an ACA-compliant plan. If this is the case, your carrier will send notification of this, and will automatically enroll you in an ACA-compliant plan that they deem similar. We highly recommend that you contact Exact Insure or your agent to explore your options. To contact Exact Insure, call us at 317-686-5767.

Conclusion

The world of health insurance is constantly changing. Regardless of the type of plan you’re currently on – no plan at all, ACA-compliant, or a “grandfathered” non-ACA plan – a lack of action during Open Enrollment will likely cost you money and frustration. Contact an insurance agent today for help navigating the murky waters.

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