A window of opportunity recently opened for individuals who want affordable health care for them and their families. The annual open enrollment period for insurance plans offered through the Federally Facilitated Marketplace (FFM) began Saturday, November 15 and ends on February 15, 2015.
Approximately 139,000 Wisconsinites purchased a plan through the Marketplace last year. The majority, or 91 percent, had incomes between 100 and 400 percent of the federal poverty level (FPL). As a result, they receive financial assistance to help defray the cost of their health insurance plan through Advanced Premium Tax Credits.
This year, these same consumers can choose to take no action and be auto-enrolled into their current or similar plan as long as the insurance company is still operating within the FFM.
While auto-enrollment may lead consumers to think that they no longer need to log into their healthcare.gov account, here are five reasons to take the time to log in and take action:
1. Update your personal information and potentially save money. Changes regarding your updated information, including marital status, income, family size etc., can affect your premiums, including the premium quoted for your current plan and the amount of your premium tax credit. This is an opportunity to shop around!
2. You may be able to get more financial assistance toward your monthly premium. Getting the right amount of premium tax credit is a delicate balance that depends on many factors. Updating your financial assistance application will help whether you stay with your same plan or enroll in a new plan. Because the recent re-enrollment notices sent out by insurance companies reflect consumers’2014 Advanced Premium Tax Credits and not their 2015 Advanced Premium Tax Credits, the current calculation may not reflect reality.
For example, the premium tax credit calculation is based on a number of factors including changes in consumer income and the federal poverty level. If financial information is not updated, premium estimates will remain based on last year’s federal poverty level rather than the most current version. For individuals and families living close to the poverty level, even a slight difference in this number is important to take into consideration.
3. Limit your exposure to repayments in the tax reconciliation process. Updated financial information may help lower your premium payment or ensure that you don’t owe money at the end of 2015 when you file your tax return.
4. Check in to see if you or a family member may be eligible for BadgerCare+. Some low-income individuals or family members (like pregnant women and children), may be eligible for BadgerCare+ which is generally more affordable than coverage in the marketplace.
5. Shop around and compare products and prices. You may want to take a look and see if there is a product or network that you like more than what you have in your current plan. Even if you are automatically re-enrolled, you can still utilize the remainder of the open enrollment period to shop around for other coverage options and enroll in a new plan. If you a pick a plan by the deadline, February 15, 2015 your new coverage will take effect on March 1, 2015.
No matter which plan you choose, remember that a little time between now and February can go a long way in helping your family get the right insurance plan at the right cost.
Important Dates
November 15, 2014-February 15, 2015: 2015 Open Enrollment Period
- 11/15/14-12/15/14: Enroll between these dates and plan starts 1/1/2015
- 12/16/14-1/15/15: Enroll between these dates and plan starts 2/1/2015
- 1/16/15-2/15/15: Enroll between these dates and plan starts 3/1/2015
December 15, 2014: Current consumers will be automatically re-enrolled in their plan or a similar plan (as described in their notification letter) if they have not taken action to re-enroll themselves or choose a new plan.
December 15, 2014: Current consumers with APTC who don’t update their financial assistance application will automatically have their 2014 APTC amount renewed for 2015.
Note: Even if consumers auto-renew they can change plans/update financial information during open enrollment even if coverage has been effectuated.
December 31, 2014: Coverage for 2014 Marketplace plans ends
Resources
Kaiser Family Foundation, “Explaining the 2015 Open Enrollment Period.” November 2014.
Tricia Brookes. “Renewing Coverage Through the Federal Marketplace.” Georgetown Center on Children and Families. November 2014.
Tricia Brookes. “Do Nothing to Renew or get an Updated Eligibility Determination? CMS puts out Final Marketplace Renewal Rules.” Georgetown Center on Children and Families. September 4, 2014.
Sashi Gregory
