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I continue to be surprised at the phone calls from individuals now that the initial open enrollment has finished for those who need to enroll for their 2016 health insurance.  As much media attention as the enrollment process has received there are still many who are unsure of the rules and the consequences of inaction.  Here are some details that may help clear some of the waters.

1-      Everyone who enrolled by December 17 for the January 1 start date should be set for the year.  If voluntary changes need to be made they will need to be completed by January 31 unless there are circumstances that produce a special enrollment opportunity later in the year.

2-      Those who did not complete their enrollment by December 17 will fall into either a February 1 effective date (if enrollment is completed by January 15) or a March 1 effective date (if enrollment is completed by January 31.)

3-      Those who fail to enroll by January 31 will be prevented from enrolling in coverage until January 1, 2017 unless there is an extenuating circumstance that produces a special enrollment opportunity like birth, death, marriage, loss of coverage due to divorce, loss of group coverage or some other approved event.  Individuals who want to enroll mid-year are not guaranteed the ability to do that.  Also, the effective date will be determined not only by the type of life event, but also the date that the requested change is made.  Tread carefully here and allow a lot of time to produce the desired result.

4-      Individuals who want to make plan changes during the year will need to experience a life event that produces a special enrollment period, so decisions need to be thought out carefully each year.

5-      Penalties for not having qualified coverage for the required number of months in a year have increased again this year.  Individuals who elect to remain uninsured need to calculate what that penalty will be as it is specific to the income and the number of family members on the tax return filed.

I will post another note as we approach the final enrollment deadlines as more questions come up.