How Open Enrollment in the Individual Ex

How Open Enrollment in the Individual Exchange is Expected to Work

Health Care Reform requires Exchanges to have an initial open enrollment period, an annual open enrollment period and certain special enrollment periods. Individuals will only be able to enroll in a Qualified Health Plan through an Exchange during one of the enrollment periods. Individuals will not be allowed to purchase coverage unless an enrollment period is available.

Initial Enrollment Period
The initial open enrollment period is expected to run from Oct. 1, 2013, through March 31, 2014. Coverage will have an effective date of Jan. 1, 2014, for qualified individuals whose Qualified Health Plan selections are received by the Exchange on or before Dec. 15, 2013. For any selections received between the first and 15th day of January, February or March 2014, coverage will be effective the first day of the following month. For selections received between the 16th day and the last day of any month between December 2013 and March 31, 2014, the Exchange must ensure coverage is effective the first day of the second following month.

Special Enrollment Periods
Qualified individuals and enrollees may be allowed a “special enrollment period” under certain circumstances (similar to a qualifying event under Section 125 plans), during which they could enroll in a plan or change enrollment from one plan to another. Each special enrollment period will be 60 days from the date of the triggering event. The effective date of any coverage elected during a special enrollment period follows rules similar to those applicable during initial enrollment. However, coverage would be effective on the date of birth, adoption or placement for adoption, when that is the special enrollment triggering event.

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One Response to How Open Enrollment in the Individual Ex

  1. Ben Rosky says:

    You will likely be able to buy insurance at other times, but the standard medical underwriting process will apply. This means the insurance company can still deny you coverage if it is not during one of these enrollment periods. In other words, you cannot wait until you get sick or hurt to by medical insurance!

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