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What is an enrollment period?

The Affordable Care Act sets aside certain time periods in which people are eligible to sign up for health care coverage, called Enrollment Periods. Currently, there are 2 types of enrollment periods:

1. Open Enrollment Period – Open enrollment refers to the time in which every eligible person is able to select a new health insurance plan or make changes to their existing health coverage. (November 1, 2018 – December 15, 2018 for 2019 coverage)

2. Special Enrollment Period – Special enrollment is reserved for those individuals who require a modified time frame to enroll in health coverage due to a qualifying life event (QLE). QLE’s are certain life changes that may require a change in in your insurance needs, and include:

Having a baby, adopting a child, or placing a child up for adoption.

Getting married.

Losing other health coverage by losing a job-based plan, aging off your parens’ coverage at age 26, divorce, or losing eligibility for Medicaid or CHIP.

Being denied Medicaid of CHIP coverage.

Moving your residence outside your insurance plan’s service area.

Gaining citizenship.

Gaining status as a member of a federally recognized tribe or shareholder in an Alaska Native Claims Settlement Act (ANCSA) Corporation.

Leaving incarceration.

Experiencing a change in income or household status that will affect eligibility for premium tax credits or cost-sharing reductions for those enrolled in Marketplace coverage.

You or your dependents’ enrollment or non-enrollment in another benefit health plan was made as a result of an error by the Health Insurance Marketplace.

You or your dependents’ demonstrated that the health benefit plan you were previously enrolled in substantially violated material provisions of the contract.

What if I miss open enrollment and do not qualify for special enrollment?

If you miss your opportunity to sign-up during the Open Enrollment Period and do not qualify for special enrollment, you will be required to pay a penalty fee on your income tax return. We can advise you on alternative coverage options (Short Term Insurance, Health Care Share Organizations, etc); however, these options do not qualify as Minimum Essential Coverage, and you may still be subject to a penalty fee.