HHS changes Dates for next Open Enrollment (in response to many complaints/concerns)

February 25, 2015

The ACA law specifically states that the Open Enrollment period for the Marketplace (that is all individuals under 65) will coincide with Medicare Open Enrollment and take place from October 15 through December 7th. The law did allow for an extended 6-month open enrollment period the first year the market opened (Oct 1, 2013 - March 31, 2014). For the 2015 enrollment, the dates were scheduled to go back to the Medicare Open enrollment, as indicated in the law. However, HHS modified the 2nd open enrollment period to 11/15/14 - 2/15/15. For 2016 enrollment it has now been changed to Nov 1, 2015 - Jan 31, 2016. Read more: http://newsmanager.commpartners.com/nahuw/issues/2015-02-20/index.html

NAHU (National Association of Health Underwriters) was very vocal on behalf of health insurance agents to explain the problems with the limited Open Enrollment time-frame of less than 2 months. Most agents who sell Individual Health Plans to people under age 65 also sell Medicare Supplement and Medicare Advantage plans to people over age 65. In addition, many sell group health insurance plans whose insurance renews at the end of the year or on January 1st. For many small offices, this is equivalent to having a tax preparer do 90% of their returns in a 5 week time frame with no extensions! Even accountants are allowed extensions, but the ACA law does not allow this for anyone. Once the O.E. ends, you cannot change your plans for any reason other than a Qualifying event. This includes loss of Employer Group coverage, getting married, getting divorced, having a baby, or a significant change in income causing you to either lose a tax credit or now be eligible for a tax credit.

While I understand needing to have a deadline for people WITHOUT insurance to enroll in a plan, I don't understand not letting people who have insurance to change throughout the course of the year. I have been selling health insurance over 25 years (since 1989) and clients were ALWAYS allowed to change their plans mid-year. In most cases, many people couldn't handle the premium and wanted to raise the deductible; this was allowed by most insurance companies without questions. In order to decrease your deductible (and increase your benefits), this typically involved underwriting in years past. While there is no longer any "underwriting" of health insurance plans (policies are guaranteed to be issued regardless of health), I don't see the issue in allowing people to increase their deductibles during the year and buy a "more affordable plan". I do understand the insurance companies not wanting insureds to go the other way - from a cheap plan to the richest plan. If this was allowed someone could buy the cheapest plan on the market and if they got sick or needed surgery, they could change to a rich plan with better benefits.