Tag Archives: Special Enrollment Period

CMS Announces Special Enrollment Period for Tax Season

Press release: CMS Announces Special Enrollment Period for Tax Season.

The Centers for Medicare & Medicaid Services (CMS) announced today a special enrollment period (SEP) for individuals and families who did not have health coverage in 2014 and are subject to the fee or “shared responsibility payment” when they file their 2014 taxes in states which use the Federally-facilitated Marketplaces (FFM). This special enrollment period will allow those individuals and families who were unaware or didn’t understand the implications of this new requirement to enroll in 2015 health insurance coverage through the FFM.

For those who were unaware or didn’t understand the implications of the fee for not enrolling in coverage, CMS will provide consumers with an opportunity to purchase health insurance coverage from March 15 to April 30.  If consumers do not purchase coverage for 2015 during this special enrollment period, they may have to pay a fee when they file their 2015 income taxes.

Those eligible for this special enrollment period live in states with a Federally-facilitated Marketplace and:

  • Currently are not enrolled in coverage through the FFM for 2015,
  • Attest that when they filed their 2014 tax return they paid the fee for not having health coverage in 2014, and
  • 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.

The special enrollment period announced today will begin on March 15, 2015 and end at 11:59 pm E.S.T. on April 30, 2015.  If a consumer enrolls in coverage before the 15th of the month, coverage will be effective on the first day of the following month.

Colorado Residents call Chris at 303.495.3045 for assistance!

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A Tale of Special Enrollment Period Issues

How The Affordable Care Act Forced Me To Become Uninsured – Forbes.

The problem described is a Federal Marketplace Issue, I can absolutely assure you it is a Connect for Health Colorado issue as well. My clients and I have encountered numerous issues with Special Enrollment Periods, particularly those that allow the applicant to apply between the 16th and 31st of the month with coverage scheduled to start on the 1st of the next month.

As November 15 – the deadline for enrollment – approached, I had not received a bill from the insurance company. I called The Marketplace, and they said I had to wait until I got a bill from the insurance company. I called the insurance company, and they said they had not received my enrollment information from the Marketplace. I called The Marketplace, and they said that yes, the insurance company could not enroll me or bill me or accept a payment until they received the information, but they had sent it. They would send it again.

I have head this story so many times, most of the time with a strong implication that it is the insurance company that is at fault.

Read the whole thing…. it makes me wanna puke.

To continue, since we are presently in open enrollment this is not a huge issue. I expect this problem to rear it’s ugly head again simply because everyone has to work as a team to fix an issue like this. I’m going to let you in on a little secret:

They are NOT working as a team!

Let me ask a simple questions:

What is transmitting and receiving data so hard?

The whole computer industry operates on accurately transmitting and receiving data. Examples that quickly come to mind:

  • Read and Write to devices such as:
    • Hard drives
    • USB sticks
  • Data transmission
    • RS 232 serial ports (what the heck are those!)
    • USB interfaces (communication with all your USB devices)
    • Wireless internet (think 3G and 4G)
    • Wired internet

And these incompetent idiots can’t transmit enrollment information in an accurate and timely manner!?

You can’t make this stuff up.

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Enrolling outside of Open Enrollment

What events, technically called Qualifying Life Events (or QLE’s) allow you to enroll outside of Open Enrollment? The Colorado Exchange or as they prefer to be called, “Marketplace” has released an excellent document that describes these events:

Continuation of Health Coverage: Know Your Options

Pay special attention if you are deciding whether to enroll in COBRA or select a plan (and possibly premium assistance) via the Marketplace. You must notify Connect for Health Colorado, or the Federal Exchange, within 30 days of your termination date.

Download (PDF, 2.61MB)

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HELP! Open enrollment is over, can I still purchase health insurance?

Yes, no, maybe so.

To avoid the Obamacare penalty and purchase a Qualified Health plan, you’re too late UNLESS a Qualified Life Event (QLE) has occurred. If you have a QLE, then a Special Enrollment Period (SEP) will be created that will allow you a specified time to enroll.

What is a QLE?

Loss of Minimum Essential Coverage due to:

  • Divorce of legal separation
  • Change in full time employment status
  • Employer no longer offering coverage
  • Voluntary or involuntary termination of employment
  • Death of parent or spouse
  • Change in dependent status (i.e. dependend child turning 26 years old)

Gaining or becoming a dependent due to:

  • Marriage
  • Birth of child
  • Adoption of child
  • Placement for adoption of child
  • Guardianshipo/court ordere dependent

Other events:

  • Permanent move to a new state
  • Existing coverage is being changed to a qualified health plan

 

When you experience a qualifying life event, you will be able to enroll or change your health insurance within 60 days of the event.

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