Open Enrollment (OE3) Begins on Sunday, November 1, and goes through January 31, 2016
The third annual open-enrollment period (“OE3”) for individuals to purchase health plans through the federal and state Marketplaces (Exchanges) begins on Sunday, November 1, and lasts through January 31, 2016. Plans must be purchased by December 15, 2015, in order to be effective January 1. Plans purchased after the 15th of the month begin on the first day of the second following month (EX: plans purchased January 16-31 take effect March 1). No one can enroll in a 2016 after January 31 unless they qualify for a Special Enrollment Period.
During OE3, 38 states will be using the HealthCare.gov website. A number of improvements have been made in the website since last year, as enumerated in this HHS Fact Sheet. It should be faster, accommodate more users, and make the sign-in and “shopping” experience easier for consumers. Two of the more important new features are:
- The Out of Pocket Cost feature, which has been added to the Window Shopping tool and provides consumers with an opportunity to get an estimate of what their premiums, deductibles, and co-pays may be for each specific plan based on a low/medium/high anticipated health care service utilization. [Note that options are ranked by premium cost rather than total costs, so it is necessary to look at the whole list.]
- The Doctor Lookup feature and the Prescription Drug Lookup feature, which will be available when a consumer is viewing plans and pricing. These features will provide consumers with searchable information about the doctors and prescription medications that different plans will include. These two features are still in development, and it is not clear when they will be available. As of last week, HHS said they currently have only a little over half of the data validated from insurance companies for these website tools to work.
See this AP article for more details about this year’s HealthCare.gov changes and some helpful tips for using the website.
Materials for Consumers
- Questions and Answers on the Premium Tax Credit from the IRS.
- Calculator for the individual responsibility payment (penalty for not having insurance in 2016) from the Tax Policy Center (of the Urban Institute and Brookings Institution)
- Preparation for Open Enrollment. Consumers can prepare to enroll by visiting this page on HealthCare.gov.
Materials for Assisters
- *NEW* Health Insurance Literacy Resource Hub (updated October 2015) and Get Covered America Get Covered Academy from Enroll America
- CMS Weekly Assister Newsletter. To sign up for the CMS Weekly Assister Newsletter, send a request to the Assister Listserv inbox (ASSISTERLISTSERV@cms.hhs.gov) and write “Add to listserv” in the subject line. Include the email address that you would like to add in the body of your email.
- From Coverage to Care Enrollment Toolkit – Summary, Resources, and Answers to Assister Questions. This Enrollment Toolkit offers advice for assisters on how to help consumers choose the best plan for themselves and their families. It addresses what consumers need to know before choosing and enrolling in a plan, such as the value of health insurance, the importance of understanding key health insurance terms, and an explanation of how to discuss updating information that might affect consumers’ coverage or financial assistance on HealthCare.gov. The Toolkit helps to explain these topics to consumers and provides further resources. Click here to view additional resources, including the Roadmap to Better Care and a Healthier You.
- Families USA Enrollment Assistance Network. The Families USA Enrollment Assistance Network has updated three resources on its Enrollment Assister Resource Center: Get Ready to Get Health Coverage (bilingual); Health Insurance Options for Latinos (English and Spanish version); and Health Insurance Basics: Key Words and Phrases You Need to Know (English and Spanish version).