Special Enrollment Period by Jake Bramlett

Did you miss the open enrollment period to sign up for health insurance through the Federal/State Exchange or through your local independent insurance agent?  This is a problem many people have encountered.  The public perception was that even if they missed the window to the enrollment period, they could still get health insurance through their local agent or directly from private insurance companies.  Our clients have been shocked to find out that the only coverage they can buy until the next open enrollment period is high deductible temporary/catastrophic medical coverage.  This coverage does not have all the bells and whistles of the Affordable Care Act plans, and you can be denied medical coverage due to pre-existing conditions or your pre-existing conditions can be excluded.  Certain individuals may be eligible for a "Special Enrollment Period" including:

• Marriage or divorce.

• Having a baby, adopting a child, or placing a child for adoption or foster care.

• Moving your residence, gaining citizenship, leaving incarceration.

• Losing other health coverage due to losing job-based coverage, the end of an individual policy plan year in 2014, COBRA expiration, aging off a parent's plan, losing eligibility for Medicaid or CHIP, and similar circumstances.  Important:  Voluntarily ending coverage doesn't qualify you for a Special Enrollment Period, neither does losing coverage that doesn't qualify as minimum essential coverage.

• For people already enrolled in Marketplace coverage:  Having a change in income or household status that affects eligibility for premium tax credits or cost-sharing reductions.

• Gaining status as member of an Indian tribe.  Member of federally recognized Indian tribes can sign up for or change plans once per month throughout the year.

The next Open Enrollment period starts November 15, 2014 and ends February 15, 2015.  If you have additional questions, please don't hesitate to give our office a call at (580) 223-7300 and ask for Diane or Jana.


Jake Bramlett
Complex Risk Advisor