When congress passed the Patient’s Protection and Affordable Care Act (PPACA) in 2010, they completely changed the rules for health insurance. Many think they went too far.
The PPACA only provides a legislative skeleton. Congress ceded their power to create law to the Executive wing of government. Most of the rules, for health insurance, that America must obey have been created by the flunkies in the Department of Health and Human Services (HHS).
They have, in turn, “delegated” the responsibilities of implementing “Obamacare” to the Centers for Medicare & Medicaid Services (CMS).
The result has been many changes. One of the most severe changes, to the individual insurance market, is in the ability of Americans to make changes to their plans.
Before “Obamacare” went into full force, on January 1, 2014, Americans could make changes to their individual insurance plans at any time of the year they wanted to. Now Americans can only make changes during a government approved Election Period.
In 2013 – 2014 there was a 6 month Open Election Period (OEP). During that time, Americans were allowed to choose which health insurance plan they wanted. However, after the Election Period ended, they did not have the ability to make changes, at any time, if they were not happy with the plan they chose. They had to wait.
“Obamacare” requires that Americans actively enroll, or make changes, to their individual health insurance plans during a 3 month Annual Election Period (AEP). Unfortunately, congress did not specify what months the AEP would take place in. The president, not congress, determines when the AEP will be.
In 2013 the OEP was hurried. It began on October 1, even though HHS had not tested its “Marketplace”. Healthcare.gov was not even close to being able to handle the thousands of initial enrolments that Americans had to complete in just 6 months. It failed miserably and loudly.
In his attempt to avoid embarrassment by delaying “Obamacare” until HHS had a system that worked properly, Mr. Obama forced a fiasco on Americans and then attempted to dismiss it by saying that the system was experiencing some “glitches.”
In 2014, Mr. Obama did not allow the AEP until after the mid-term elections. He did not want to allow voters to see how high health insurance premiums would be for 2015. The AEP went from November 15 – February 15 for purely political reasons.
The dates for the 2015 AEP are changing again. This year the AEP will start on November 1 and will end on January 31, 2016. All Americans will have the chance to make changes to their individual plans during that time.
When the “Obamacare” rules were being consider by the bright minds in D.C. they realized that there would be times, during the year, that people would need to make legitimate changes to their individual health insurance plans. Because of that, the politicians in D.C., created Special Election Periods (SEP). You can see what the SEP qualifications are at the link in this article. Americans typically have only 60 days, from a qualifying event, in which they are allowed to make changes.
The one exception to the 60 day rule is when CMS declares a SEP.
When Healthcare.gov crashed, again, on the last day of the 2015 AEP, CMS declared a 1 week SEP for those people who were “in line” when Healthcare.gov crashed. They were given an extra week to “finish” enrolling.
CMS has granted another SEP for March 15 – April 30. This is not another Annual Election Period that is open to all Americans. This SEP is only available to people who meet the following requirements.
- Have completed their 2014 tax return and owe the Shared Responsibility Payment
- Do not already have an individual plan through Healthcare.gov
- Did not fully understand the consequences of not having “Obamacare” compliant health insurance
If you are confused about this SEP, use the form below to contact me.