Open Enrollment Ends

More Ohioans Are Benefiting from Health Insurance

2015 Open Enrollment (OE2) “officially” ended Sunday, February 15. With 234,507 Ohioans re-enrolling or signing up for the first time for Marketplace coverage, this represents a 51 percent increase over last year’s total.

 

OE2 Fast Facts:

• On February 15 alone, more people signed up for coverage than on any other day during this year’s Open Enrollment or last
• Eight in ten consumers had the option of coverage for as little as $100/month
• Across the country there are 10 million less people uninsured from 2013-2014

 

Eligible consumers still have an opportunity to gain Marketplace coverage. 

Last week, three Special Enrollment Periods (SEP) were announced:

 

“In-line” SEP 

For consumers unable to enroll in coverage through the Marketplace at the end of Open Enrollment (February 15) because of technical issues or long Call Center wait times.

Consumers eligible for the SEP:

1. Are not currently enrolled through the Marketplace
2. Have not been terminated from Marketplace coverage during OE2 
3. Attest that they attempted to enroll during OE2, but did not complete the process (“in line”) by February 15, 2015 because they experienced: 
1. a technical issue with HealthCare.gov that prevented them from completing enrollment by February 15, or 
2. an extensive Call Center wait on February 13, 14 or 15

• This SEP started February 16, 2015 and ends February 22, 2015. 
• Enrollments completed during this SEP will have a coverage effective date of March 1, 2015. 
• Eligible consumers can activate the SEP via the Call Center or HealthCare.gov.

 

Tax-related SEP 

Consumers that found out they must pay the Shared Responsibility Payment (fine) because they did not have coverage in 2014 are eligible for a SEP if they:

1. Live in states with a Federally-facilitated Marketplace (FFM),
2. Are not currently enrolled in 2015 Marketplace coverage, 
3. Attest that when they filed their 2014 tax return they paid the fee for not having health coverage in 2014, and 
4. Attest that they first became aware of, or understood the implications of, the Shared Responsibility Payment after the end of open enrollment (February 15, 2015) in connection with preparing their 2014 taxes. 

• This SEP does not apply to consumers who do not have to pay the penalty but are subject to reconciliation and have to repay APTCs. 
• This SEP begins on March 15 and ends on April 30. 
• Consumers who qualify must complete the entire enrollment process (that is, including selecting a plan) by 11:59 pm on April 30, 2015.

 

SEP for consumers that don’t received Medicaid denials until after Open Enrollment: 

If consumers applied for coverage through the Marketplace or Ohio benefits and found out they were denied for Medicaid or CHIP, they may eligible for a SEP. Consumers have 60 days from their Medicaid determination date to renew.

 

MEDICAID

In addition to Ohioans gaining health insurance through the Marketplace, another 471,340 Ohioans enrolled in the Medicaid program through January 16. Last year 526,378 Ohioans enrolled in Medicaid.

Eligible residents can enroll in Medicaid year round.

At this time, many beneficiaries are receiving notices that they must complete and send in the redetermination information required to verify their continued eligibility in the Medicaid Program. Ohio’s FQHC CACs can help with this process. Please click here to find a CAC nearby. (LINK TO PDF OF CACs)

 

LOOKING AHEAD

Open Enrollment 3 (2016) dates were released last week. 

November 1, 2015 – January 31, 2016 will give consumers three full months to shop and according to HHS, will “aid consumers in finding a health plan that best suits their needs.”

Rules for OE3 clarify standards for qualified health plan (QHP) issuers to publish up-to-date, accurate, and complete provider directories and formularies.  Issuers also must make this information available in standard, machine-readable formats.

In addition, there are rules around better transparency, premium stabilization programs, formularies, interpreter services and SHOP. The final rule was placed on display at the Federal Register on February 20 and can be found here