Who should shop (or re-shop) for health insurance during the AEP?
Posted by Sharon Nuttall on Tuesday, October 27, 2015 Under: Annual Enrollment Period
As I write this, we are moving very close to the opening day for shopping for 2016 health plans. The Annual Enrollment Period runs from November 1st through January 31st. This is the third AEP under the Affordable Care Act (ACA or "Obamacare"). Let's take a look at who can benefit from this opportunity to comparison-shop among plans.
They include those who are:
They include those who are:
- Currently without health insurance, including those who have short-term (also called 'temporary') insurance, since those do not meet the requirements of the ACA. Not having creditable health coverage in 2016 could result in your having to pay a hefty penalty (which is increasing again in 2016) at tax time.*
- Having current coverage cancelled. Lots of companies are having to "tweak" current plans, either to meet changes required by the federal government or because the insurers were losing money. Some insurers are changing their network options, so they're cancelling plans using those networks. They will be automatically moving you to the plan they think is the next best choice for you for 2016. Do you really want a health insurance company choosing your health plan for you??!
- Receiving a subsidy. Subsidy amounts and eligibility change every year, along with the available plans. Just taking the passive route and letting your plan and subsidy roll over to next year may mean you're paying more for your health insurance than you need to be. It's always a good idea to revisit your options.
- Currently on a "grandfathered" or "transitional" plan. A grandfathered plan is one which was in place prior to March 23, 2010. A transitional plan is one which became effective after that date but before January 1, 2014. Transitional plans were set to go away when the ACA went fully into effect in 2014, but have been allowed to remain through 2016 because of the pushback from citizens who had heard Obama say, "If you like your plan, you can keep your plan." Both types of plans were often less expensive for some people who had gotten low rates because they were healthy. However, over time and with annual rate increases (and changes in people's income making them subsidy-eligible), they may well not be the "deal" they were back at the end of 2010.
- Covered under a spouse or parent's group health insurance. Many employers, particularly in small businesses, pay some or all of the cost of the employee's health insurance but are not able to afford to do the same for the employee's families. It's worth checking to see if you can get a lower-cost individual plan for the family.
- On COBRA. Even though you have the option to keep COBRA for, in most cases, up to 18 month, you should check to see if that's still the best choice for you. If you don't make the change to go onto your own health plan during the AEP, you will have to keep the COBRA plan for all of 2016 or until the end of your COBRA eligibility, whichever comes first.
- Anticipating an income change in 2016. Will you be retiring, moving to a straight-commission position, reducing your working hours, or any of the myriad reasons for a predictable reduction in income in 2016? Conversely, do you anticipate a fairly substantial income increase that will affect subsidy eligibility? In either case, it's smart to re-run the numbers and look at the plans. What was a fit in 2015 may be all wrong in 2016.
Bottom Line: Once we hit November 1st, take a few minutes to run a quote (I'll have a link on the home page of this website) or feel free to contact me and I'll email you one! Nothing ventured, nothing gained, as the saying goes. And there's a LOT to be gained by choosing the right plan at the right time.
*If you don’t have a health plan that qualifies as minimum essential coverage, you may have to pay a fee for the months you’re uncovered. For 2016 the fee is the higher of these two amounts: 2.5% of your household income; or $695 per adult ($347.50 per child), up to a maximum of $2,085. You’ll pay the penalty on your federal income tax return.