Affordable Care Act open enrollment period has begun

November 15, 2014, marked the start of 2015 Marketplace open enrollment for Affordable Care Act, Qualified Health Plan. The enrollment will go until February 15, 2015.

To enroll, visit www.healthcare.gov.

“Remember, if you have an employer-sponsored health plan and it is affordable, which means it is not greater than 9.5 percent of your household income, you are eligible to purchase a plan in the Marketplace but not eligible for any premium tax credits,” said Carrie Johnson, SDSU Extension Assistant Professor & Family Resource Management Specialist.

Johnson reminds South Dakotans, that if they have not enrolled by Feb. 15, they will not be able to purchase a plan through the Marketplace until the next year’s enrollment period unless they are eligible for a Special Enrollment Period.

Special Enrollment Qualifiers include:

• 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 (voluntarily ending coverage does not qualify);

• 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 a federally recognized tribe or shareholder in an Alaska Native Claims Settlement Act (ANCSA) Corporation (members of federally recognized Indian tribes can enroll in or change plans once a month throughout the year.

What if I’m already enrolled?

For individuals enrolled during the 2014 period, Johnson said their coverage will end on Dec. 31, 2014. To continue coverage in 2015, they can renew their current health plan or choose a new one.

“If you had a plan in 2014, your insurance company may automatically enroll you for 2015 but they will need to notify you of this,” she said.

She explained that if you do not have health insurance during 2015, you may have to pay a fee of 2 percent of you income OR $325/adult and $162.50/child; whichever is more. The 2015 fees are a significant increase over the 2014 fee schedule.

During the Open Enrollment Period, if you enroll:

• If you enroll between the first and the fifteenth of the month, your coverage starts the first day of the next month example: You sign up and pay the first month’s premium on December 5 – your coverage will begin January 1.

• Between the sixteenth and the last day of the month, your coverage starts the first day of the second following month example: You sign up and pay the first month’s premium on December 17 – your coverage will begin February 1.

For more information regarding the Affordable Care Act and how it may affect you visit www.healthcare.gov.