Time is running out to enroll in ACA compliant insurance

By Greg Grisolano, Land Line associate editor | Thursday, January 21, 2016

Time is running out to enroll in health insurance in 2016 before the open enrollment period ends for good.

For 2016, the open enrollment period runs until Jan. 31. With that cutoff, this year’s open enrollment period will end two weeks earlier than last year. It’s also crucial to remember that your enrollment date is not the same as your effective date. For example, if you enroll between Jan. 16, 2016, and Jan. 31, 2016, your effective date is March 1, 2016. 

If you are not already enrolled in a public or private health care plan or do not have health insurance through an employer-provided plan, the open enrollment period is the time to purchase coverage or risk paying a tax penalty.

Those who do not enroll in a qualifying plan during the open enrollment period will be unable to purchase health insurance in 2016 unless they have a qualifying event such as loss of job, marriage, divorce, birth of a child or by moving to another state.

Those who purchased plans through a public or private insurance marketplace will have the opportunity to renew the same plan or shop for different coverage during the open enrollment period. In most instances, you will be automatically re-enrolled in your same plan. However, if your insurance company withdraws from the particular state marketplace you are in altogether, your coverage will lapse and you will need to pick a new plan and provider.

A recent report from the Kaiser Family Foundation predicts that the average individual penalty for not having insurance will rise to $969, an increase of 47 percent over the previous year.

The ACA mandates enrollment in a qualified health insurance plan for most Americans. For those not exempt by law, failure to do so will result in a penalty assessed on your federal income taxes. The tax penalty is increasing to 2.5 percent of your yearly household income for not enrolling in a qualified plan during 2016. The maximum penalty is the national average premium for a Bronze insurance plan. Fees are paid as a part of the filing process for federal income tax returns.
 
Due to significant changes to the health care insurance marketplace that were brought about by the ACA, the Medical Benefits Group at the Owner-Operator Independent Drivers Association has a limited number of states where it can offer major medical coverage to Association members. As the market changes, so could the availability of coverage in these and other states. The Medical Benefits Group will continue to assist OOIDA members with obtaining coverage in certain states and will be available to offer advice and guidance to members in general.

One of the ways in which the ACA attempts to make health insurance more affordable is by offering tax subsidies to qualified individuals who purchase insurance through state or federal exchanges. Those applying for subsidies must fall between 133 percent and 400 percent of the federal poverty level in order to qualify.

Although the individual mandate requires most Americans to carry a minimum level of insurance coverage, there are some important exceptions and special qualifications. Those exemptions include certain religious groups and Native American tribes; undocumented immigrants (who are also not eligible for insurance subsidies); incarcerated individuals; people who have VA medical care; people whose incomes are below the threshold for filing tax returns; and people who live in states that have not expanded Medicaid programs and would have qualified for Medicaid under the expanded coverage.

For a full list of exemptions and information on how to file for one, visit HealthCare.gov.

Consumers with questions are encouraged to contact the HHS call center at 800-318-2596 or visit the HealthCare.gov website they can find local help. Agents in OOIDA’s Medical Benefits Group are also available from 7:30 a.m. to 5:30 p.m. CST, Monday through Friday, at 800-715-9369 or via email at medben@ooida.com.

 

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