The initial open enrollment period starts on October 1st, 2013 and ends on March 31, 2014. During this initial period you can apply for coverage and be guaranteed acceptance. No pre-existing condition exclusions are allowed.This initial open enrollment period will last six months because of the amount of time needed to get 5.3 million new people enrolled in California. In future years the open enrollment period will be between October 15th and December 7th (at the same time as the Medicare annual enrollment period).
How Does The Initial Open Enrollment Period Effect Uninsured People
During this initial open enrollment period, those of you that have no health insurance can get coverage. To make sure your new coverage starts on January 1st 2014, you’ll need to apply before December 15th. If you apply after 12/15, then your plan will start on February 1st.
As long as you enroll and the policy starts by April 1st 2014, you will not have to pay a penalty. The Affordable Care Act states that you can be uninsured for up to 3 months without owing a penalty.
Already Have Health Insurance – How Does The Initial Open Enrollment Period Effect You
The initial open enrollment period will have different effects on people that already have medical insurance. Each insurance company in California is sending a letter to their subscribers outlining what will happen to you during the initial enrollment period.
Grandfathered Health Insurance
For those of you that have Grandfathered health plans (policies you started before March 23, 2010) with an insurance company that is still active in California, this initial open enrollment period will not effect you. Your current policy will continue to cover you in 2014. However there is a dark cloud on the horizon.
The insurance companies are now telling us they expect to see some people in grandfathered policies move to new Obamacare coverage to get increased benefits and/or subsidies to lower premium costs. If enough people leave, then the people left in grandfathered plans may see their premiums go up faster in future years.
Non-Grandfathered Health Plan – Anthem Blue Cross and Blue Shield of California
Anthem and Blue Shield have decided to transfer their current members from their non-grandfathered medical plans into a new Obamacare plan that is similar in benefits (not price). At this point you should have received a letter outlining how your policy is being mapped to the new health care reform options.
If you like the new plan they have chosen for you, then you have nothing to do. If you don’t like the benefits or price, you have until December 15, 2013 to select a new plan and notify the insurance company of the change.
From the information the insurance companies send me regarding the mappings for my clients, I expect there will be a lot of people changing coverage.
If you or your family can qualify for a subsidy, then we will need to make a change during open enrollment, and sign up on the Covered California (CoveredCA) exchange. Contact our office and we will help you with this change.
Non-Grandfathered Health Plan – Health Net and Kaiser Permanente
Health Net and Kaiser Permanente are simply cancelling all their subscribers on December 31st and requiring their subscribers move into new health care reform policies. Your letter will provide a list of their new “Metal Plans” with a benefits description and the rates for you and your family.
To change to one of these new metal plans, Health Net and Kaiser have provided a transfer form that allows you to select the coverage you want to be moved into. The deadline to submit this form is November 15th. It is important that you not miss this deadline, because your policy will stop covering you on 12/31/13.
If it looks like you can qualify for a subsidy, then contact our office and we’ll help you get that set up through the CoveredCA exchange.
Non-Grandfathered Health Plan – Cigna
Cigna has some special flexibility during the initial open enrollment period that could be very useful to you. Because Cigna is only selling coverage outside the exchange, and not participating in the CoveredCA exchange, they are not required to move all their subscribers to health care reform policies on January 1st 2014.
Cigna intends to renew all subscribers on December 31st and enable them to stay on their current Cigna plan until December 31, 2014. At that point you will be required to move into Obamacare.
This renewal process would allow you to delay the larger cost increases of Obamacare in 2014. The lowest cost Cigna policies are actually a little bit richer in benefits than the Bronze plans. But the Cigna plans usually cost less.
Once you have found the best option in the new health care reform plans, be sure to compare that policy with the Cigna medical insurance options that are available. It might make sense to “Opt Out” of Obamacare in 2014.
Go back to the Impact On Families And Individuals.