Open enrollment is a short window once a year where you are able to apply or renew for health insurance for yourself and/or your family. It is important to be aware of those dates, as you don’t want to miss the designated period. In the case that you do miss your open enrollment period, here are the steps you can take to prepare and avoid missing it again.

What is Open Enrollment and How Long Does it Last?

Open enrollment is the period of time where you can make changes to or enroll in insurance coverage. This may be through your employer, spouse, or a state insurance marketplace. The Affordable Care Act makes it easy to get coverage if you are not supplied through your employer. That open enrollment period is generally during the last few months of the year, but open enrollment periods through your employer can change depending on plans offered and when those plans began.

You generally have one month to complete your insurance enrollment. Leading up to open enrollment, you will likely go through an insurance presentation, where you learn of your options and have a chance to ask questions regarding coverage and plans.

 

What are the First Steps to Take if You Missed Open Enrollment?

Missing open enrollment can mean different things for different people based on your circumstances. If you have automated renewal set up for your benefits plan, you would be automatically signed up for your current plan, providing you with benefits, but not allowing you to make any changes to your plan, if that was something you were hoping to do during open enrollment. You would not be able to make changes to your plan until the next open enrollment period or until you qualify for a special enrollment period based on a series of qualifying events. If you are not set up for automatic renewals and miss open enrollment you have a high probability of not being able to receive insurance through your employer or a spouse’s employer for that year. 

One step you can take if you miss enrollment is to attempt to get a special circumstance, allowing you to enroll through your employer, which may be more plausible as opposed to state-run programs. You may also be subject to fees, therefore it’s important to determine what fees you may face and ensure those get paid. They may be applied to tax returns, so do your research and find that out when the time comes.

Other Options for Healthcare Coverage

If you missed your open enrollment period through your employer, you still have the option of enrolling in a plan through your state marketplace. Thanks to the Affordable Care Act, everyone is entitled to health coverage. This can be done through your state programs at the beginning of the year. Depending on when your employer coverage enrollment ended, you may still have a chance to get coverage through a state-mandated program.

Second, Medicaid offers coverage for low-income citizens based on a few circumstances. Find out if you are eligible here.

Lastly, you may be able to purchase short-term coverage through private insurance companies. People who are between plans or need to buy time until they can enroll will purchase these plans. If eligible, you could continue to enroll and maintain this temporary coverage until the next enrollment period. However, it is not considered “minimum essential coverage,” which means it may be subject to fines. 

Penalties for Not Having Health Insurance

Plans that you had up until 2018 would potentially have had a fee applied when you paid your federal taxes. This fee was called the Shared Responsibility Payment. To avoid paying the fee you would either have to file an exemption based on certain circumstances or have lived in a state with their own individual mandates that would apply to state taxes. If you did not have insurance for the plan year in 2019, that penalty no longer applies. Find more information on Healthcare.gov.

How to Plan Ahead for Open Enrollment

Going into open enrollment with a solid plan is your sure-fire way of ensuring you get enrolled on time and the right way. A few things you should do before open enrollment include:

  • Talk to your family and compare plan options. Your spouse’s plan may be better than yours, or it may make sense to each be on your own for financial purposes. 
  • Pay attention during any information sharing or insurance presentations at your place of employment. That is your chance to get all the information you’ll need to make informed decisions during open enrollment.
  • Once you know the enrollment deadline, put it in your calendar, with a reminder for a few days ahead. You don’t want the reason you missed open enrollment to be because you were late.
  • Visit Healthcare.gov to get more detailed information on what options you have outside of your employer.
  • Read through all the plans and documents and do a mock enrollment. If you practice and determine exactly what you want to sign up for ahead of time, enrollment will be a breeze.

 

Planning ahead, staying informed, and setting a deadline reminder are all great ways to make sure you don’t miss your open enrollment. However, if you missed the open enrollment window due to unforeseen circumstances, know that you aren’t completely out of luck. There may still be options for you. For more information on open enrollment and how to make it even easier for you, your employees, or your employers, reach out to Benequick today. We have the tools and resources to ensure a seamless 2021 enrollment.