What is Open Enrollment?
Open enrollment is a window of time when people can sign up for health insurance. They can also make changes to their coverage, or drop their health insurance coverage. Healthcare open enrollment was only for employer-sponsored health insurance, but with the passing of the Affordable Care Act, it was introduced to the individual market in 2013. This made individual coverage similar to group coverage and those who were previously denied for pre-existing conditions, can now get coverage.
The only other way to buy a health insurance plan outside of open enrollment is to qualify for special enrollment.
What does open enrollment mean? During open enrollment, you can purchase a policy from the state’s health insurance marketplace, Covered California. Coverage can begin as soon as January 1, 2020.
What you can do during Covered California open enrollment:
- You can renew your current individual/family health insurance plan.
- You can choose a new health insurance plan through Covered California or Freeway Insurance
If you are currently enrolled in a Covered California health insurance plan, it will automatically renew. Please note that your plan may make changes to its provider network, co-insurance, copays, and prescription drug coverage. You should receive a notice of any changes it will make for 2020.
The Covered California enrollment period is only for health insurance. Open enrollment is not for life insurance, car insurance, or supplemental insurance. Those insurance products are sold privately and can be purchased at any time.
When is Open Enrollment 2020?
2020 open enrollment for California is October 15 – January 15, 2019.
What if I Have Coverage Through My Employer?
If you have health insurance coverage through your employer, then the Obamacare open enrollment does not apply to you. The ACA open enrollment period is only for the individual, or private, health insurance market.
Employers will hold their own open enrollment periods. Your employer will communicate those dates with you. Be on the lookout for emails from your HR department about your open enrollment. This usually happens in the fall so that coverage can begin January 1 of the following year.
Preparing for Open Enrollment 2020
You will need to gather important documents for your health insurance application. Having these documents readily available will make then open enrollment process a lot easier. You will need:
- Tax returns
- Social security numbers for everyone you are applying for
- Current health plan information (if you have it)
- An understanding of the health care plans on the marketplace
What is a Special Enrollment Period?
Special enrollment period is the time when an individual can modify their current health care plan coverage based on any new changes that have occurred. These changes can be implemented outside of the open enrollment period, but only during a qualifying life event.
Examples of qualifying life events:
- Becoming a United States citizen
- Involuntary loss of other coverage
- Having a baby or adopting a child
- No longer eligible to stay on parent’s insurance plan
- An income change that makes you newly eligible (or ineligible) for the marketplace
- A permanent move to an area where new health plans are available
- Became a widow or widower
- New job
If you voluntarily canceled your health insurance coverage or your insurance lapsed due to non-payment, you are not eligible for a special enrollment period.
Typically, you have 60 days from the date of your qualifying life event to make changes to your current plan.
Proof of Documentation of Your Qualifying Event
If you want to make changes to your health care plan, or want to enroll outside of open enrollment, then you will need to provide proof of your qualifying life event. You can do this during your special enrollment period (SEP).
Here are examples of common qualifying life events and proper documentation:
|Qualifying Event||Eligible Documents|
|You have a new baby, or you adopt||Add your child(ren) to your existing plan.||Adoption papers or birth certificate|
|You get married or divorced.||After marriage, you have 60 days to join your spouse’s plan; if you lose coverage because of a divorce, you are eligible for SEP.||Marriage certificate or your court papers that show that you stopped receiving health care coverage because of the divorce.|
|You gain U.S. citizenship||Becoming a citizen qualifies you for special enrollment||Provide your naturalization certificate or certificate of citizenship|
|You move to a new zip code||Must be a permanent move to a new region or state that does not offer your existing plan||You will need proof of residency and a letter from your insurer that shows that you had coverage for at least one day during the 60 days before your move.|
Penalty for No Health Insurance
The ACA required nearly all Americans to have health insurance. If you could afford it, but chose not to buy it, you were charged a penalty called the individual Shared Responsibility Payment on your federal tax return. In 2017, Congress eliminated the penalty. However, those who received a penalty for not having health insurance in 2018 will stay have to pay that penalty on their 2019 taxes. The 2018 tax penalty is $695 for adults and $347.50 for children, or 2% of your annual income, whichever is higher.
If you don’t have medical insurance coverage in 2019, the fee no longer applies. However, state lawmakers in California are reinstating the penalty for 2020.
What Happens if I Miss Open Enrollment?
If you miss open enrollment, your opportunity to enroll in a health insurance plan will be almost non-existent. You will only be able to sign up if you experience a qualifying life event. If you miss the 2020 open enrollment period, and you don’t experience a qualifying life event, you will not be able to sign up for health insurance until the next open enrollment period. That won’t start until the fall of 2020, and your coverage wouldn’t begin until January 2021.
Do I Always Need a Qualifying Event to Sign Up Outside of Open Enrollment?
Native Americans and Alaskan Natives can enroll anytime during the year. If you are eligible for Medi-cal or CHIP, you can also enroll anytime.
Medi-cal is California’s Medicaid health care program that offers free or low-cost health coverage for children and adults with limited income. You can apply online at CoveredCA.com. You can also apply in person at your local county human services agency.
CHIP is the Children’s Health Insurance Program. The program provides no-cost or low-cost health care coverage to children in families that earn too much to qualify for Medi-cal. California residents can apply for CHIP online, over the phone, by mail or in person at enrollment centers.
You can also sign up for travel insurance and short-term health insurance outside of open enrollment.
How Do I Sign Up For Health Insurance?
Freeway Insurance offers affordable health insurance plans for you and your family. We provide customized options based on your budget and needs. You can get a free health insurance quote online, or you can call us at 800-777-5620 to speak with an expert insurance agent who can answer your questions and help you find a health insurance plan that works best for you.