2016 Open Enrollment for the Affordable Care Act

The 2016 Open Enrollment for the Affordable Care Act (ACA) begins on November 1, 2015.

This means that everyone who currently buys their own (non-group health insurance) has a chance to change plans—and even insurance companies—for 2016.

Open enrollment for 2016 plans runs from November 1, 2015-January 31, 2016. Here are some helpful tips:

  • If you want to change your coverage for January 1, you need to enroll by December 15, 2015. The ACA rules state that you need to sign up by the 15th of the month prior to the month you want to start coverage. If you sign up on December 16, your ACA coverage will not start until February 1. If you sign up on January 31, you are still in the open enrollment, but your coverage will not start until March 1.
  • Almost all of the 2015 plans are changing for 2016. This means that if you are currently enrolled in an ACA plan and do nothing, you will be “mapped” to the most similar plan to yours in 2016 by your insurance company.
  • If you were eligible for a Premium Tax Credit (PTC) through the exchange for 2015, you should absolutely re-apply for 2016 to capture changes for both you and the Marketplace.
  • The penalty for not carrying insurance for 2016 is increasing significantly. Contact your tax preparer for the new rules.
  • If you enroll on the exchange, authorize your agent to work with them on your behalf. You can authorize them for up to a year and it will certainly save you a headache if any issues arise.
  • The companies available for NH for 2016 include Anthem BCS, Community Health Options (formerly Maine Community Health Options), Harvard Pilgrim Healthcare, and Minuteman Health.
  • Make sure you understand they type of network your plan has: HMO, PPO, HSA, etc.
  • Make sure your preferred doctors and hospitals are in the network for the plan you choose.
  • Make sure your prescriptions are covered on the plan you choose.
  • If you are a sole proprietor or have a fluctuating income, you should consider applying through the Healthcare exchange, even if you are currently making too much money for a Premium Tax Credit for 2016. Should your income change in 2016, your accountant will not be able to apply the PTC at tax time if you do not go through the exchange.
  • Get professional help in choosing your plan for 2016. You will pay exactly the same amount of premium whether you use professional help or not, so it makes sense to get the help you deserve.
  • If you have a “Grandfathered” plan and choose to keep it for 2016, you will not be able to change it until January 1, 2017. This can become an issue for those whose plans renew after the open enrollment. Your “Grandfathered” plan may have a large price increase at renewal time, and you will be stuck if you are outside the open enrollment.
  • If you choose to COBRA a group health plan outside of the Annual Open Enrollment period, you will not be able to change to an ACA plan until the next year’s annual open enrollment period.

Don’t forget that The Paige Agency is here to help you! Call us at 603-435-6767 to seek professional advice before the Open Enrollment period begins. Visit our past blogs to learn more about the process and the role we can play in making it that much easier for you.