2020 open enrollment is closed. That includes any Special Enrollment Periods (SEP) enacted this year due to Coronavirus. You can see more on those dates here.
Anyhow, that means it’s time to start planning for 2021 enrollment. With most open enrollment dates being in November and December for a January start date, it’s never too early to start. Planning a pain-free open enrollment can be difficult for some businesses, however, if you have the right communication, the proper dates, and a robust enrollment software solution, you should be ready to go!
Open Enrollment Dates for Job-Based Insurance Plans
If you receive insurance through your employer, they can set the open enrollment date, which means it can happen at any time of the year. However, more often than not, employers will follow the same open enrollment deadlines as the ACA mandate and other Special Enrollment Periods. In this instance, you can generally expect to enroll for new insurance every year, with an effective date in January or February.
Some people may sign up for insurance every year in December, while some may have effective dates in the middle of summer. Either way, it’s good to pay attention to open enrollment dates both at your job or if you are considering signing up for another insurance plan, like Obamacare. Always be mindful of deadlines for each plan.
When is the Open Enrollment for Obamacare?
Obamacare, or the Affordable Care Act, allows people who do not have insurance through their employers, or who opt-out of job-offered insurance, to still get coverage. The “Obamacare” mandate was signed into effect in March of 2010 and has allowed millions of Americans to sign up for affordable healthcare coverage. In 2020 alone, it’s estimated that the Affordable Care Act currently covers 8.3M people.
Healthinsurance.org is an excellent resource for both federal and state insurance information and questions. First, it’s important to note that not all states use the same exchange platforms for open enrollment and health insurance management. For example, only thirty-eight states, thirty-five by the start of 2021 enrollment, use Healthcare.gov to sign up for health insurance. Thirteen states use their own state-based marketplace, and the rest of the states use a combination of the two. For example, in Minnesota, our health insurance exchange is MNsure. It is where any eligible Minnesotans, who don’t have insurance through their employer, family, or spouse, will go to sign up for their health insurance. For most states, those who use Healthcare.gov for enrollment, dates for 2021 coverage will run from November 1, 2020, through December 15, 2020.
State Specific Open Enrollment Dates to Be Aware of
The health insurance exchange used by your state can affect when open enrollment deadlines are, but many adopt the federal dates of November 1 through December 15 this year. Some states have unique circumstances and varying deadlines. Three states, in particular, have permanently extended open enrollment deadlines. New York, California, and Washington D.C. have extended their open enrollment dates to run from October 15 thru January 31. Colorado and Pennsylvania’s new state-run insurance exchange will hold open enrollment from October 15 thru January 15.
There are also seven additional states that, although they run under the federally mandated exchange, have a marketplace plan management exchange. The states have more power to oversee the plans and can even sell qualified health plans in their specific exchanges. Those states are Kansas, Montana, Nebraska, Ohio, South Dakota, and Virginia.
Those states with state-run exchanges can have a bit more control over their open enrollment deadlines. For example, states in the past have done one or two-day extensions to make up for customer service centers being closed on the weekends. If the deadline landed on a day call centers were meant to be closed, it would be appropriate to extend that deadline to a day where applicants could have customer service resources available to them.
What Circumstances Qualify as a Special Enrollment Period?
The only time an eligible person could apply for health insurance outside of the open enrollment dates is if they have a life event that qualifies them for a SEP. Federal or state-based exchanges will give a window of 60 days for a SEP, while job-based plans must provide at least 30 days. Qualifying events that would allow a person to change or opt-out of their insurance plan outside of open enrollment include:
- Getting married
- Getting divorced
- Having a baby
- Adopting a child
- Losing insurance coverage (circumstances may vary)
- Moving to another state
- Becoming a U.S. citizen
- Becoming a permanent resident of the U.S.
- Job-based plans renewing or changing
- Losing or gaining a job
- Enrollment error that was due to the exchange or insurance company
Those are the most common and straightforward qualifying life events that would allow for a change in insurance coverage outside of the open enrollment period. Check with your insurance provider or employer for more information on what circumstances would apply. Also, keep in mind that all special enrollment circumstances require proof of the qualifying life event with official documentation.
For employers, TPAs, or brokers looking for a pain-free open enrollment this year, contact BeneQuick for more information or to get a free demo. BeneQuick helps make the enrollment process easy while also making it simple to review, maintain, and change coverage as needed. Click here to request a demo!