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Health Subsidy and First Open Enrollment Window
We've discussed how eligibility for health subsidies will work but when you can actually apply for coverage and the resulting health subsidy on a qualified Exchange plan? Great question and the first open enrollment window will be quite different from following ones so let's understand this time period to make sure we don't miss out on any health subsidies that we're eligible for since $1000's of dollars are at state.
The October 1st, 2013 Kick off to health subsidy enrollment
The health reform bill means that 10's of millions of people will be making changes to their health insurance in 2014 which is no small undertaking. Due to this initial roll-out, the first health reform and subsidy open enrollment window will be 6 months long starting Oct 1st, 2013 and ending March 31st, 2014. If all goes according to schedule, you will be able to quote and apply for the new Exchange plans and health subsidy directly through our Health Subsidy Quote page. Even though the app can be submitted October 1st, the earliest possible effective date will be Jan 1st 2014.
Effective dates during open enrollment window will be based on app submittal date
Make sure to plan ahead of your desired effective date as the earliest available effective date will be based on when the application is received. Each State might have different takes on this so make sure to run your instant quote and access online application to see available effective dates. A rough estimate is that if you apply in the first 15 days of a month, you might be able to get the following 1st of the month. For example, if you apply Jan 5th, you might be eligible for Feb 1st. If you apply in the last half of the month, you might expect your effective date to be moved one month forward to the next 1st of the month. For example, if you apply Jan 20th, you might get a March 1st effective date at the earliest. Pending changes, we expect the last day to submit an application during this open enrollment window to be March 31st, 2014. Again, make sure to verify through quote page or directly with your State to make sure. Our advice is to plan and apply ahead. Health subsidy calculation and application is automatically handled through the application process. What happens if you miss this window?
Outside Health Exchange open enrollment window
What if you don't apply by March 31st 2014? That could be trouble. There will be special qualifying events that allow people to off-enrollment window (such as losing group health insurance, etc) but otherwise, you'll have to wait until the next open enrollment window which will occur at the end of 2014. We don't expect many of the States to provide high risk pool options to exist after Jan 1st 2014 since the Exchange plans are guaranteed issue (regardless of health) so make sure to enroll as soon possible especially if you're eligible for a health subsidy which should reduce the health insurance premium significantly. We'll publish the qualifying events when released that allow people to come on mid-year. Going forward after the first Enrollment window, there will be a new open enrollment window at the end of each calendar year. Keep in mind that plan/carrier changes will likely not be allowed outside of open enrollment window.
Los Angeles, Family of 4
making $60K. Subsidy=$8,388*
Iowa, Single Adult making $30K
*Based on age, expected costs, and other assumptions according to Kaiser Calculator. Actual subsidies will vary and official subsidy amounts will be available Oct 1st, 2013.
Health Subsidy Calculator
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