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alifornia health insurance  -  Health Reform in California  -  Open enrollment window

California Health Reform Open Enrollment Window

One of the biggest changes as a result of the ACA (Affordable Care Act) is the addition of Open Enrollment periods.  This was added as result of guaranteed issue (cannot be declined due to health) to make sure that people do not wait until they get sick to apply for coverage.

It's very important to understand how this works and what do outside of the Open Enrollment window.

The Standard Open Enrollment Window

Each year, from Nov 15th through Feb 15th (please check with us each year since their are typically revisions, extensions, etc to this timeline), an eligible California person can enroll or change health care plans both through Covered California and off-Exchange.  There is verbiage about making the period from Nov 15th to Dec 7th but this is probably unviable (too short).

Effective Dates During Open Enrollment

There are specific rules for effective dates available during the Open Enrollment:

  1. If you submit your application before the 16th of the month, you may be eliglible for the following 1st of the month
  2. If you submit after the 15th of the mont, you may be eligible for the 2nd following 1st of the month
  3. If you are losing health insurance, you may be eligible for the following 1st regardless of when submitted during the prior month

Guaranteed Issue and California health enrollment

Covered Ca agentA big change in California will be that you cannot be declined for coverage due to health if you enroll during the open enrollment window (mentioned above) or due to a SEP (Special Enrollment Period). We do not have the rules out on what the SEP's are but the usual suspects (leaving group health insurance, exhausting Cobra, etc) are probably targets. There will also be penalty for not enrolling outside of a few rare situations (hardship, etc). Okay, so that's the rough sketch of health insurance qualification and the stick designed to enforce it.

How To Apply Outside of Open Enrollment Period

What if you apply for health insurance after the final date in Open Enrollment? Unless you qualify due to a SEP, you'll have to wait until the next open enrollment unless you experience certain large life events.

You can find more information on the Covered California Special Enrollment triggers here

To some extent, this strengthens the "mandate" to get coverage which is good otherwise, the prices will skyrocket if people can just enroll when they get sick.  Please call us at 800-320-6269 to see if your situation might meet a Special Enrollment requirement.

You can run your Health Quote here to view how the plans cover Chiropractic benefits. Click on the "Benefit Details" for more detail. 

Again, there is absolutely no cost to you for our services.  Call 800-320-6269 Today!

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