Health insurance: closed for business
- 15
- Feb
- 2015
- Posted ByChris Nesbitt
- InAffordable Care Act, Healthcare, Obamacare
- Comments Off on Health insurance: closed for business
To (almost) quote a Loverboy hit from 1982, I hope you’re healthy when it’s over.
ObamaCare open enrollment was from November 15, 2014 to February 15, 2015. During that time you were able to enroll, switch plans, and apply for subsidies. All Private Health Plans share the enrollment period prescribed by the Health Insurance Marketplace (aka Exchange), while employer based coverage, Medicaid, and Medicare have their own unique enrollment periods.
That window has now closed. Perhaps you let it laps purposefully, and you wouldn’t be alone. On the other hand, it’s possible the deadline blew passed you while you weren’t paying attention.
So what happens if you missed it? Turns out, you actually have quite a few options within three categories: You can either apply for special enrollment, qualify for an exemption, or prepare to pay the fees. Let’s look briefly at each of these.
Pay the fees. The penalty for not having coverage will be paid on your Federal Income Tax Returns, based on your Modified Adjusted Gross Income (MAGI), for each full month you or a family member doesn’t have health insurance or an exemption. Depending on your coverage, income, and family size you will either pay a flat dollar amount, or a percentage of income above the tax return filing threshold for your filing status. The fee is capped at the national average for a Bronze health plan available in the marketplace, and is only paid for full months you or a family member went without coverage. The fee is technically called an “Individual Shared Responsibility Payment” and is part of the Affordable Care Act’s Shared Responsibility Provision.
Qualify for an exemption. You could qualify for an exemption from the individual mandate to have health coverage if:
- You aren’t required to file a tax return because your income is too low
- Your lack of insurance coverage was for only three months or less
- The lowest-price health care coverage amounts to more than 8% of your income
- You are part of a Native American tribe
- You are in the U.S. illegally
- You are a member of a health care sharing ministry
- Your religion objects to insurance
- You are incarcerated
- You qualify for a hardship exemption
Applying for an exemption may take some effort, and the necessary application form depends on the exemption. Some exemptions can be claimed when you file your taxes; whereas others, like being a member of a religion that objects to insurance, require you to fill out an application form. These forms and related instructions can be found on the Healthcare.gov website.
Apply for a special enrollment. You can qualify for a myriad of reason, discussed in detail here; but the basics are as follows:
- Your health insurance plan is changing to include the new benefits required under health care reform in 2014
- Renewal of an individual medical plan in 2014 (grandfathered or non-grandfathered)
- You lose health insurance that is Minimum Essential Coverage due to:
- Discontinuation of a current plan that does not meet health care reform requirements
- Employer no longer offering group health insurance
- No longer qualify for government-sponsored insurance
- Divorce or legal separation
- Termination of a domestic partnership or civil union (in states where applicable)
- Change in full time employment status
- Voluntary or involuntary termination of employment
- Death of parent or spouse
- Change in dependent status (i.e. dependent child turning 26 years old)
- Change in student status; for example, graduating from college
- You are gaining or becoming a dependent due to:
- Marriage
- Domestic partnership (in states where applicable)
- Birth of child/children
- Adoption of child/children
- Placement for adoption of child/children
- Guardianship/court ordered dependent
- Other:
- Permanently moving to a new state
- Return from active duty
- Release from incarceration
- Gaining citizenship or valid immigration status
If you need help determining which option is best for you, let me know.
Search
Recent Posts
- Nations Largest Insurer Regrets ObamaCare
- Vesity Financial merges with NorthPointe Insurance
- Banking on Babylon
- The Implosion Begins
- Case Study: Crohn’s Disease and IUL
Categories
- Economy (6)
- Healthcare (19)
- Affordable Care Act (17)
- Healthcare Sharing Ministries (2)
- HIPPA (1)
- Obamacare (17)
- Retirement (20)
- 401k (7)
- Benefit Plans (1)
- Debt (1)
- Executive Bonus Plan (1)
- Fixed Indexed Annuities (5)
- Indexed Universal Life (5)
- IRA (2)
- IUL (1)
- Life Insurance (2)
- Oil (2)
- Savings (1)
- Section 162 (1)
- Social Security (2)
- Stock Market (6)

Thanks for visiting! I Look forward to hearing from you. -Chris
Chris did an amazing job helping my company setup a retirement plan that was very specific to our company and our industry. We have been very pleased … Read more
I cannot thank you enough for your quick response and site visit. Our Site Manager called today to thank me, and let me know what a great service you … Read more
Chris provided an amazing way for my artists to save money and reduce costs. Chris has taken each individual artist and customized a plan according to… Read more
Chris was a great help, and setup a retirement plan specific to our unique needs.”
Chris was diligent in finding us just the right plan to fit our needs and our business. And we found a great relationship in him as well. Thanks Chris… Read more
Chris set up a retirement plan that met our company’s unique requirements”
Through Chris Nesbitt’s committed leadership, Vesity Financial Inc has brought both excellent service and exciting opportunities to the Gilson Daub … Read more
Chris Nesbitt is the best. I have worked with several financial consultants over my 30 years as an attorney and as an investor. Chris explained the av… Read more
I have known Chris Nesbitt for over 15 years. He is a man of integrity, with whom I would entrust any of my worldly possessions, including my life sa… Read more
After we received notification from our health insurance company that they were cancelling our existing group plan due to the ACA, Chris helped us nav… Read more