Open Enrollment Period Archives - Page 3 of 4

How Will Your Health Insurance Plan Change in 2022?

All health insurance plans change every year: you’ve probably noticed that your prices go up, or that different things are covered from year to year. But sometimes, the rules surrounding health insurance plans also change, as they are set to in 2022. Next year, aside from the newly extended Open Enrollment Period and the Special Enrollment Period for low-income applicants, there will also be some updated rules and regulations for the ACA and the Marketplaces put into a document called the Notice of Benefit and Payment Parameters. Knowing what changes are coming next year will help you make an informed decision about your health insurance plan during the Open Enrollment Period.

Out-of-Pocket Maximum Capped

hundred dollar bills sticking out of a pocket — *New out-of-pocket maximums for 2022 are $8,700 for individuals, and $17,400 for a family.*

For 2022 health coverage, the out-of-pocket maximum, or the most you have to pay for covered services in a plan year, will be $8,700 for individuals, and $17,400 for a family. The only plans that this does not apply to are grandmothered or grandfathered plans, as well as short-term plans and fixed indemnity plans.

The proposed out-of-pocket cap for 2022 was originally $9,100 for individuals and $18,200 for families, but this was changed after the Department of Health and Human Services (HHS) listened to public comments. The HHS decided that they would lower the limits, with some health plans having out-of-pocket limits well below $8,700 for individuals. These plans include employer-based health plans and metal tiered plans for family and individuals.

And if you qualify for cost-sharing reductions, your maximum out-of-pocket limits will be even lower. You can receive cost-sharing reductions if your household income is no more than 250% of the poverty level and you select a Silver plan.

The out-of-pocket maximum for you plan depends on your household income; the new income levels and limits for 2022 are:

If your income is between 100% and 200% of the poverty level, your out-of-pocket maximum will be approximately $2,900 for an individual and $5,800 for a family.
If your income is above 200% but no more than 250% of the poverty level, your out-of-pocket maximum will be approximately $6,950 for an individual and $13,900 for a family.

A New Special Enrollment Period

If you lose your health insurance coverage because of a job loss, you qualify for a Special Enrollment Period (SEP), which allows you to buy a health insurance plan outside of the Open Enrollment Period. But what if you are on a government- or employer-sponsored COBRA plan? What happens when that plan ends? Well, if your subsidy ended on or after September 30, 2021, a SEP will open up to you. That means you now have the option to transition to a plan on the exchange after your subsidy ends; you can also receive the ACA’s premium tax credits if you are eligible based on President Biden’s new subsidy extensions.

If you need more information on the changes coming to plans for next year, or need help finding a plan during the Open Enrollment Period, an EZ agent can help you. We will provide you with a local licensed agent who will search all available plans in your area and find the best one for your medical and financial needs. We will also double check to see if you qualify for any subsidies to save you even more money. All of our services are done in minutes and at no cost to you. To get free instant quotes, simply enter your zip code in the bar above, or to speak to a local licensed agent call 888-350-1890.

What Information Will You Need in Order To Enroll in a Health Insurance Plan for 2022?

The Health Insurance Open Enrollment Period, or ACA Open Enrollment Period, begins on November 1st and runs through December 15 in most states, or through January in a select number of states. You can change your healthcare plan during this time, or if you don’t have health insurance, this is the time of year to enroll. In fact, this is the only time you can enroll in an ACA plan, unless you experience what’s known as a “qualifying event” (like getting married or having a child), which would open up a Special Enrollment Period for you. Before you enroll in a plan, though, it’s important to first find out what kind of information you will need to complete your application.

Finding A Plan

illustration of a person holding a large magnifying glass looking through — *The best way to find a plan is to compare each plan in detail, and the easiest way to do this is by working with an EZ agent.*

Before we get into what you will need to enroll in a plan, let’s review how to find the best plan for your needs. The only way to make sure you’re getting the best plan for your needs is by comparing every available plan in your area, but this can be overwhelming and time-consuming, so make things easier on yourself by working with a licensed agent, who will have access to info on every plan’s coverage and price. An EZ agent can compare plans in minutes for you for free, saving you time and money, while finding the best plan for your medical and financial needs.

Be Prepared

While searching for a plan, you will need some important information to not only find the right plan, but to save you as much money as possible. To make the process go more smoothly, be prepared with:

Your name, address, email address, social security number, and birth date.
Your household size and income, with proof in the form of your pay stub, W2, or tax return. You’ll need this info for any plan you want to enroll in, but you’ll definitely want to use your financial info to check if you qualify for any premium subsidies or cost-sharing reductions, which could save you hundreds of dollars.
All of your doctors’ names and locations so you can make sure that the plan you’re considering covers them. If your doctors are not in the plan’s network, you could end up with some surprise medical bills.
Any medications you are taking. Each plan has its own drug formulary, meaning each plan places medications in one of 4 tiers, which affects how much the drug costs. It is important to make sure that your medications are covered, and that they will not be too expensive for you.
Payment information, preferably a credit or debit card.

black question mark in a yellow circle — *The OEP normally ends December 15, but it is important to check within the state you live in, as some have extended the deadline.*

When Your Plan Will Go Into Effect

Once you’ve given all of this information to your agent, and you are all set with an affordable plan, your next question might be “When will my plan go into effect?” In states where the ACA Open Enrollment Period ends December 15, coverage will take effect on January 1st. If you already have a plan, and are switching to a new plan, your current plan will end December 31st, and the new one will begin January 1. If you are in one of the states that has an extended Open Enrollment Period through the month of January (California, Colorado, Massachusetts, Nevada, New Jersey, New York, Pennsylvania, Rhode Island, Washington, and Washington D.C.), your new plan’s coverage will begin February 1st.

Need Help?

It is possible to find affordable plans, and with President Biden’s American Rescue Plan Act (ARPA), which expanded premium subsidies to more Americans, you could save anywhere from $50 to $1,000 a month. Finding an affordable plan can be time-consuming and confusing if you’re doing it on your own, but it’s so much easier with an EZ agent; with help from one of our agents, you can cut down on time and stress, and save as much money as possible. Our highly trained agents work with the top-rated insurance companies in the country, and can compare plans for you in mere minutes; not only that, but our services are completely free. To get free instant quotes and guidance, simply enter your zip code in the bar above, or to speak to one of our local licensed agents, call 888-350-1890.

New IRS Rule Allows Mid-Year Plan Changes

There are many ways you can describe the health insurance system, but when it comes to enrollment, “flexible” isn’t always one of them. Each year, you choose your company’s plan and your employees have a set enrollment period (either the ACA open enrollment period or another one of your choosing) during which they can sign up. Once they do, that’s pretty much it for the year, unless they experience a qualifying life event, like marriage or the birth of a child. But 2020 hasn’t been an ordinary year. The IRS has decided to recognize this fact and allow mid-year changes to healthcare plans, and they are leaving the decision about whether to allow these changes up to you, the employer.

What the IRS Is Allowing

cafeteria plan written on a white piece of paper — *The IRS has decided to allow mid-year changes to healthcare plans including cafeteria plans.*

If you offer your employees a healthcare plan under IRS Section 125 – otherwise known as a Cafeteria Plan – and/or a flexible spending account (FSA), then you have a decision to make this year. The normally rigid rules surrounding when and how employees can make changes to these plans have been suspended by the IRS, and you now have the option of letting them make a one-time change to their plan. This comes at a time when employees may need relief from premium payments, extra coverage, or even more time to use their FSAs. You are not required to let employees make any changes, but if you decide to, you can allow them as many options as you like, including:

Enrolling in the plan if they had previously declined coverage
Changing from a higher to a lower cost plan, or vice versa
Moving from family to individual coverage, or vice versa
Dropping coverage, but only if they have another plan in place

Again, you don’t have to allow all or any of these changes. You also have to be sure that you make the options fair and equal to everyone. The IRS even suggests that employers only offer options that would improve healthcare coverage, such as moving from an individual to a family plan or from a plan that covers very little to a more comprehensive plan, to make clear that these changes are meant to benefit your employees, not simply lower your premium contributions.

In addition to changes to their healthcare coverage, employees now also have more flexibility when it comes to their FSAs. Your employees might be finding it harder to make the most of their FSA dollars these days because they haven’t been going to the eye doctor or dentist, for example. If they use these accounts for dependent care, they may have been unable to send their children to summer camp this year. For this reason, the IRS has extended the grace period for using 2019 funds through the end of 2020. Employees will also be able to roll over more of their funds through 2021.

What Employers Need to Consider

Your employees might welcome the chance to change their insurance policies right now, but you also have to think about how it will affect your business. Consider:

How it will financially impact your business if employees drop their plans, especially if it is the healthier employees who opt out and the employees who need more care who stay in
Your plan’s requirements. If your plan is fully-insured, there may be a minimum number of participants, so having employees opt out or change plans might mean having to rethink your whole healthcare policy.
The admin! It will take a lot of time and resources to review and process all of the changes.

It’s a tough decision to make. These are crazy times, and both you and your employees have a lot on your plates. As a small business owner who may already be struggling to provide healthcare, but who also wants the best for your employees, you may want to allow changes, but limit them. Consider following the example set out by the IRS and offer your employees the ability to enroll in or upgrade their plans. You can also decide to do an emergency stock-take: throw together a mid-year employee health survey and see what is on your employees’ minds. You have until December 31, 2021 to adopt your plan (which can be retroactively implemented), so don’t stress too much!

If you find yourself completely confused, then remember, EZ’s knowledgeable agents can answer any questions you have. And if you find YOU need a change in policy for your company, then come to us for instant, accurate, free quotes. We’re ready, willing, and able to shoulder some of the burden of small business healthcare, so get started with us today. Simply enter your zip code in the bar above. Or to speak with an agent directly, call 888-350-1890. No hassle, no obligation!

Can You Get Health Insurance at Any Time?

If you are unhappy with your current health insurance policy, then it might be time to shop for a different plan. But can you purchase a new plan at any time? Yes, and no. For marketplace plans, once the open enrollment period (November 10 to December 15) is over, you generally cannot get a new plan. The open enrollment period for employer-based insurance might be at a different time of year, but you will still only be able to change your plan during that enrollment period. In most cases, if you want to get health insurance or change your plan outside of the open enrollment period, you will need to qualify for a Special Enrollment Period (SEP). SEPs open up when you experience what is known as a qualifying life event.

Qualifying Life Events

caucasian couple hlding a baby girl in the middle while both are kissing each cheek — *You can get health insurance outside of open enrollment if you qualify for SEP such as getting married or having a baby.*

You have 60 days to change your plan if you:

Got married
Had a baby, adopted a child, or took in a foster child
Got divorced or legally separated. However, if you do not lose coverage due to divorce or legal separation, then you do not qualify for a Special Enrollment Period.
Had someone on your marketplace plan die
Changed residence. If you move to a new home in a new ZIP code or county, move to attend school, are a seasonal worker and move between job and home, or move from a shelter or other transitional housing to a permanent residence, you will qualify for an SEP.
Lost your health insurance. This includes losing job-based coverage, losing a plan you bought yourself, losing eligibility for Medicaid or Medicare, and losing coverage through a family member.
Gained membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
Became newly eligible for Marketplace coverage because you became a U.S. citizen
Left incarceration
Started or ended service as an AmeriCorps State and National, VISTA, or NCCC member

Short-Term Medical Plans

If you do not qualify for any of the life events listed above, all hope is not lost. You can enroll in a short-term medical plan. Short-term health insurance provides fast, flexible insurance with many benefits. These plans can be extended up to 3 years, and you can pick your deductible amount from many options. You are also able to drop coverage without a penalty if you want to change to a long term insurance option. Premiums are lower than ACA health insurance plans, and you get coverage as soon as a day after applying.

It is important to understand that short-term insurance is temporary and not ideal for those who require more comprehensive coverage or have health conditions. Short term plans are not guaranteed-issue, meaning they do not cover pre-existing conditions. They only cover the basics.

Do you qualify for a special enrollment period? If not, are you considering a short-term health insurance plan to hold you over until open enrollment begins? EZ.Insure can help. We offer accurate health insurance quotes based on your specific region, free of charge. That’s right. We will provide you with an agent who will compare all available plans for you, and help you choose a health insurance plan that is based on your health needs and budget, for free. To get your free quotes, simply enter your zip code in the bar above, or to speak to an agent, call 888-350-1890.

Is There Open Enrollment for Group Health Insurance?

Open enrollment is defined as a period of time when an employee join your group health plan or make changes to their existing policy. If you have a Group Health policy, which you should if your business employs over 50 workers, then any changes outside of a SEP will need to be made during this open enrollment period. Your employees need to be notified so that they do not miss this opportunity.

squares and finger pointing at them — *Open enrollment is the standard period for insurance changes. Do you know the exact dates?*

The unfortunate downside is that if the deadline is missed, then they must wait until next year. However, certain qualifying life events exempt an individual from this rule. You can learn more about that here. <link to SEP article>

For Employees

Open enrollment for the 2019 period will start Friday, November 1, and it will run until Sunday, December 15, 2019.

With your employment-based policy, your staff should receive reminders in the mail, but make sure to either talk to them one-on-one or send them an email yourself.

Health coverage is important, and taking the time to reach out will send a positive message to your employees. They will appreciate your knowledge, guidance, and interest in their well-being.

For Business Owners

You do not have an “open enrollment” period to make changes to your company’s group health policy. You can make changes whenever you’d like.

business owners in their company — *Knowledge is power! Keep in mind important dates when it comes to making policy changes.*

If you want to change your business’ policy, you can (usually) cancel your coverage at any time, but the insurance company prefers to be notified at least 30 days in advance. It would be courteous to let your employees know as well.

For these changes, it’s good to review the pros and cons of joining an HRA or switching to a different policy. Both are valid options, but the choice ultimately falls on what would be best for your company’s future.

Don’t worry about big insurance decisions; EZ.Insure offers solutions. Your agent will answer any questions you have, compare the plans available to you, and even sign you up when you are ready, free of charge. To get started simply enter your zip code in the bar above, or you can speak to an agent by emailing replies@ez.insure, or calling 888-998-2027. EZ.Insure makes the entire process simple, easy, and quick.

Plans Rates to Increase in 2018: Silver Costing More than Gold

Plans will be at least 34 percent higher in 2018 due to Trump’s decision to halt cost-sharing subsidy payments to insurers.

Because the Trump administration ceased these cost-sharing payments to insures, insurance companies raised premiums to compensate for the loss of these reimbursements. This termination of subsidies has also caused some insurers to drop out of the marketplace, leaving regions with only one insurer.

The changes

Silver plans pay for about 70 percent of customers’ health costs, with the remainder of payment left for the customer. These plans are purchased by nearly 80 percent of customers. The cost of silver plans is increasing an average of 34 percent next year.

Bronze plans, the second most popular plan, covers 60 percent of customers’ health costs. These plans are purchased by about 23 percent of customers. The cost of bronze plans is increasing an average of 18 percent in 2018.

Gold plans are usually the priciest, covering 80 percent of customers’ health costs. These plans are purchased by about 3 percent of customers. This year, the cost of gold plans are increasing an average of 19 percent.

Platinum plans are the most expensive plans, covering 90 percent of customers’ health costs. These plans are purchased by less than 1 percent of customers. The cost of platinum plans is rising by an average of 24 percent next year.

Gold plans usually have higher monthly plans and lower out of pocket costs than silver plans, but that has now changed. Now silver plans are more expensive than the gold plans that have lower deductibles.

Who this will affect

Customers who will be affected by these price increases are those who must purchase Obamacare because they do not have insurance through employers or Medicare. People who qualify for government subsidies will benefit from the premium increase of silver plans. As the premium increases for next year, enrollees will receive higher premium tax credits, allowing them to have a plan with a lower deductible, copays, and less out of pocket spending.

However, people who do not qualify for government subsidies will have to pay more for a silver plan. The least expensive gold plan for next year will be cheaper than the least expensive silver plan. So many people will probably opt to purchase the bronze or gold plan next year.

If you make more than the poverty line, in some states, a gold plan will cost less and have a lower deductible. Also, a high deductible bronze plan will have lower premiums. For example, a 40-year-old individual making $30,000 and eligible for a tax credit will pay 54 percent less in 2018 for their premium of the lowest-costing bronze plan, 9 percent less for the lowest-costing silver plan, and 16 percent less for the lowest-costing gold plan.

Gold plans are a better option in some states such as Pennsylvania, Wyoming, New Mexico, Kansas and Texas. Below is a map of highlighted states where gold plans are lower than silver plans by $25 or more.

Need Help?

Comparing plans for the upcoming year, and choosing one can be difficult. EZ.Insure can help you compare all the plans in your area, and assist you in choosing the ideal plan. Whether gold or silver is the cheapest, or bronze or platinum will suit you, EZ.Insure will make it an easy decision. Enter your zip code in the bar above to receive instant quotes in your area. You can also email replies@ez.insure or call 888-350-1890 to get started!