adult couple reviewing bills and open enrollment materials

4 Myths About the Individual Health Insurance Open Enrollment Period

We’ve heard a lot of Open Enrollment myths over the years and want to set the record straight.

Myth #1 “There are fewer insurers to choose from.”

Many carriers who initially fled the federal exchange have returned and now offer plans alongside others who have entered the marketplace. This increase in the number of plans being offered has allowed many individuals and families to re-examine their needs and adjust their coverage amounts accordingly.

In addition to having access to the same carriers and plans listed on the federal exchange, your association’s marketplace or exchange can offer members even more options. To view the full range of available ACA-compliant health plans, please visit your association’s exchange or marketplace.

Myth #2 “The premiums are too expensive.”

Now that the federal exchange marketplace has stabilized, there may be lower-cost options for ACA-compliant health plans than past Open Enrollment periods. For example, Blue Cross Blue Shield has filed for a 2.03% decrease in premiums in Texas.

Even if your coverage needs remain the same, you may be able to find a lower premium being offered by a different insurer. We recommend always reviewing the health insurance options available to you during the annual Open Enrollment period.

Myth #3 “You’ll be penalized at tax time for not having insurance.”

In previous years, if an individual did not have health insurance for more than 2 months of the year and did not qualify for an exemption they would face a tax penalty of $695 or 2.5% of their taxable income (whichever amount was greater). As of January 1, 2019, the tax penalty known as the individual mandate has been repealed, though some states may still enforce penalties on individuals who don’t have health insurance.

Myth #4 “Applications are processed instantly.”

On average, our team will process an enrollment application within 24 business hours and submit it to the carrier. Once the application is with the carrier, their team will take over and require an additional 10-15 business days to process the application.

The carriers often get overwhelmed with applications during the Open Enrollment period, so we recommend enrollees submit their health insurance applications as early as possible.

Securing ACA-Complaint Coverage for 2020

This year, Open Enrollment runs from November 1 through December 15 with a coverage effective date of January 1, 2020. This is the one time of year where individuals and families can enroll in ACA-compliant health insurance plans.

Ready to start shopping? Visit your association’s exchange or marketplace to shop ACA-compliant health plans today.

Not sure where to start? Schedule an appointment with one of our licensed benefits counselors and let us walk you through finding the best health insurance fit for your needs.

happy family on couch browsing health insurance options on tablet

Getting the Most out of Open Enrollment

With 2020 Open Enrollment period in full swing, families across the country are reviewing their current insurance coverages and seeing what other options may be available to them. Below are a few tips to help you navigate the process.

  1. Learn the Language

Insurance jargon may be enough to make some people’s heads spin but learning just a few key terms could help you pick the best health coverage for you and your family. To make it easy, here are a few words we feel you should know:

  • ACA-compliant” refers to plans that follow all the guidelines and regulations in the Affordable Care Act. These plans are only available during the annual Open Enrollment period or through a Special enrollment period, if you have a qualifying event.
  • Non-ACA plans” also known as short term health plans do not adhere to all of the Affordable Care Act’s guidelines and regulations.
  • Deductible” the amount of money you must pay out of pocket before your insurance kicks in
  • Premium” the amount you pay to your insurance company every month
  • In-network” refers to a provider that has a contract with your insurance provider
  • Out-of-network” refers to a provider that does not have a contract with your insurance provider
  1. Think of the Future

No one can predict the future, but you may be able to take an educated guess as to what the next 12 months could hold. Thinking about the coming year could help you determine how much coverage is right for you and your family. Have you had any health issues in the past year? Are you taking any medications? By examining your current health status and concerns you may be able to narrow down your health insurance plan options.

  1. Utilize Your Resources

Did you know you have access to our team of licensed Benefits Counselors? Our Benefits Counselors are experts in their field and are standing by to help you navigate the Open Enrollment process and find the best health insurance for you and your family’s needs.

We’ve been providing health insurance answers and guidance for over 30 years. Be sure to visit our Individuals page for access to appointment scheduling services, webinar replays, and other informational resources designed to help make the Open Enrollment process as quick and easy as possible.

  1. Know Your Deadlines

Like last year, the annual individual health insurance Open Enrollment period began on November 1 and will run until December 15. For those who enroll in one of these ACA-compliant plans, you can expect an effective date of January 1.

Non-ACA plans typically do not follow the ACA open enrollment period dates and are available in most states year-round.

Ready to make your decision? Visit https://memberbenefits.com/individuals/ today to secure ACA-compliant coverage for you and your family in 2020.

business man sitting at a cafe discussing his health options on his cell phone

I Missed Open Enrollment and Need Health Coverage — What Are My Options?

The next official ACA Open Enrollment period isn’t slated to begin until November 1, 2019. But depending on your circumstances, you may not have to wait that long to obtain coverage.

Qualifying Life Events and Special Enrollment Periods

Sometimes our circumstances change, and if they change due to specific events, you and your dependents may be able to secure health insurance through a Special Enrollment Period. When this occurs, it is called a Qualifying Life Event, otherwise referred to as a QLE.

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county map of missouri and kansas

Blue Cross Abandons Affordable Care Act Insurance Exchange in Missouri

UPDATE 6/13/2017: 

St. Louis-based Insurance company, Centene Corp., has announced plans to enter the Missouri, Kansas, and Nevada Affordable Care Act insurance exchanges in 2018. In April of this year, Centene CEO Michael Neidorff was quoted as saying “As to exchanges, we see nothing at this point to prevent us from proceeding with our 2018 marketplace participation.

According to Kansas City Business Journal, “As of March 31st, Centene served about 1.2 million exchange members, up about 500,00 from the previous year.” Centene Corp. is also expected to expand its six current markets in Washington, Indiana, Ohio, Georgia, Florida, and Texas signaling the potential for even more growth in 2018.

In a statement, Neidorff said, “Centene recognizes there is uncertainty of new healthcare legislation, but we are well positioned to continue providing accessible, high quality and culturally sensitive healthcare services to our members” according to an article on Reuters.

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Essential Health Benefits of the Affordable Care Act

The Affordable Care Act (ACA) mandates that all healthcare plans offered in the United States provide coverage for certain “essential benefits” beginning in 2014. Also known as mandated benefits, these benefits are designed to ensure every American receives coverage for their basic healthcare needs. The ACA has also mandated these benefits be extended to state Medicare and Medicaid programs.

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Back to School: Health Insurance for College Students

Having health insurance is a must for any college student that is going away to school. There are a number of options available for college students depending on individual circumstances, including student plans, subsidized coverage, or remaining on their parents’ health plan.

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