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The first Affordable Care Act open enrollment period that started in October of 2013 ends on March 31, 2014. Unless you qualify for a special enrollment period, you will not be able to enroll in coverage until the next open enrollment period. The next open enrollment period starts on November 15, 2014 and ends on Valentine’s Day 2015.

The open enrollment period for the Affordable Care Applies to both on exchange and off exchange policies. The rules for boh on and off exchange policies are virtually the same with the exception of the fact that only on exchange (marketplace) policies can be subsidized. This post goes over some of the rules that apply to individuals and families that purchase their own insurance as opposed to those who get insurance through their employers or businesses.

If you do not have a health insurance policy that meets the minimum standards by March 31, 2014, you may pay a penalty when you file your taxes next year. HUSKY (Medicaid) and Medicare meet the minimum standards. Employer-sponsored coverage and individual/family plans typically do as well.

How do you qualify for a special enrollment period?

You can enroll or make changes to your health insurance policy at other times of the year if certain life events occur. If you qualify for a special enrollment period, you will have a limited time to take advantage of it. 60 days is the limit.

Qualifying life events include:

  • Having a child
  • Getting married
  • Losing your coverage involuntarily due to:
    • Divorce
    • Job loss
    • A move
    • Not being able to renew your present plan

If you have a blessed event, whether it involves medical professionals (birth) or legal ones (adoption) you can add your child to your policy or enroll in a new policy. However, be sure to do so as soon as is practical. If you wait more than 30 days to add your newborn to your policy the coverage may not be effective retroactive to the date of your child’s birth.

Please check your policy to see what the deadlines are.  The first month of life often involves costly medical intervention.

You have 60 days after the date of your marriage to enroll in coverage.

If you lose coverage due to a divorce, job loss, a move or due to your insurer refusing to renew your present policy you will be able to enroll in coverage without waiting for the next open enrollment period. Losing your coverage voluntarily because, for example, you failed to pay the monthly premiums will not create a special enrollment period.

If you move to another state or if you move to a new area within your state where new insurance options are available, you will likely qualify for a special enrollment period.

If you purchased a policy in 2012 or 2013, you will probably not be able to renew it again. If renewal is not an option, you will have 60 days to enroll in a new plan.

Do you questions about the new Federal law and how it applies to you?

If you live in Connecticut, we can probably answer your questions. Please feel free to call us at 203-374-3645 if you have a question, would like to sign up or would otherwise like to take advantage of our services.

If you are from another state, you may want to visit Healthcare.gov or irs.gov for answers.

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Alston

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