Open Enrollment for the Affordable Care Act

Well here we are, just a few short days away from November… So what am I thinking about right now? Football? Thanksgiving? Nope – health insurance! That’s right, starting on November 1st, it’s Open Enrollment time for the Health Insurance Marketplaces. This means that individuals and their families will have a short window of time to apply for new health insurance, or to switch to a different health care plan in the Marketplace under the Affordable Care Act (the ACA).

So here are some things you need to know.

If you want to enroll or change plans for new coverage to start on January 1st, you have between the first day of November and December 15th to get it done – just about six weeks total. If you miss the deadline, the only way to enroll in a Marketplace health plan is to qualify for a special enrollment period. That period is the 60 days following certain life events that involve a change in family status, like a marriage, or the birth of a child, or loss of other health coverage.

This six-week window is a change from previous years, where you had until January 31st to enroll. Not anymore. But some states that run their own marketplaces have extended the window: California, Colorado, DC, Massachusetts, Minnesota, New York Rhode Island, and Washington all have extended their deadlines.

There are a few other changes you should know about.

One involves the special enrollment period I mentioned earlier. In order to qualify, you now have to provide verification through documentation of any qualifying event. Before, all you had to do was tell them you were eligible. So no more of the “honor system.”

Another change involves the amount of coverage that each plan provides. Previously, if you had, say, a Silver Plan, it would have to cover at minimum 68 percent of your medical expenses. Now it only has to cover a minimum of 66 percent of those costs.

Also, the President has indicated that the federal government will end cost-sharing reduction payments to insurers who give discounts to people with incomes under 250 percent of the federal poverty level. But some members of Congress are trying to make sure those subsidies continue.

So what this means is that the health care situation is changing – we just don’t know what we’ll be left with once it’s all said and done. If you have any questions on how this all might affect you, give us a call. We’re here to help.

Information presented should not be considered specific tax, legal, or investment advice. You should always seek counsel of the appropriate advisor prior to making any investment decision. All investments are subject to risk including the loss of principal.

No client or prospective client should assume that the information contained herein (or any component thereof) serves as the receipt of, or a substitute for, personalized advice from Lucia Capital Group, its investment adviser representatives, affiliates or any other investment professional.

Raymond J. Lucia Jr. is chairman of Lucia Capital Group, a registered investment advisor and CEO of its affiliated broker/dealer, Lucia Securities, LLC, member FINRA/SIPC. Registration with the SEC does not imply a certain level of skill or training. Advisory services offered through Lucia Capital Group. Securities offered through Lucia Securities, LLC.

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