This is a friendly reminder of several deadlines that are approaching.
Deadlines for INDIVIDUAL & FAMILY HEALTH PLANS (Either On-Exchange Covered CA plans or Off-Exchange plans)
(1) Deadline to enroll or change plans for a Jan. 1st effective date is Monday, Dec. 15th
(2) Open enrollment runs from 11/15/14 to 2/15/15. The deadlines corresponding to each effective date are:
Deadlines for each Effective Date
12/15/14 for 1/1/15
1/15/15 for 2/1/15
2/15/15 for 3/1/15
(3) If you are currently receiving a subsidy, then you must Renew by logging into Covered CA with your User ID and Password in order to re-certify to continue receiving the subsidy. (4) If you are uninsured, you may enroll by Dec. 15th to avoid a penalty in 2015.
Deadlines for EMPLOYERS WITH SMALL GROUP PLANS
(1) Groups on Grandfathered or Grandmothered plans will already have renewed on Dec. 1st.
(2) All groups, whether Grandfathered or Grandmothered will have a chance to change to new ACA plans with another insurance carrier on Jan. 1st.
(3) If you are dissolving an Employer Group plan and allowing employees to buy individual plans, they need to enroll by Dec. 15th for a Jan. 1st start. (Note that Individual health plans have significantly smaller Provider Networks than Group plans, and smaller Drug Formulary lists. Each of your employee will need to research their providers and formularies carefully before making a switch. Not all employees will qualify for subsidies. Employers are not allowed to use pre-tax dollars to pay for employees’ Individual plan premiums.)
Deadlines for SENIORS ON MEDICARE PLANS
(1) The deadline to change from a Medicare Advantage MA-PD plan (HMO or PPO) to another is Dec. 7th.
(2) The deadline to change from a Medicare Prescription Drug PDP Plan to another is Dec. 7th.
(3) For Medicare Supplement (or Medicare Gap) Plans there is no deadline and no renewal is necessary. These plans will continue as long as you continue paying the premium.
(4) For those of you who received termination notices from Scan Health and Health Net Medicare Advantage plans, you must enroll before Dec. 31st for a Jan. 1st effective date. Since some carriers will be closed during the holidays, you should submit these applications 2 weeks before Dec. 31.
(5) If you are on a Medicare Advantage MAPD plan and wish to switch to a Supplement plan and a PDP plan, you may do so, guarantee issue, only under 13 specific conditions. Otherwise, underwriting approval may be required and the timing of the switch can be tricky. The ideal time to make a change is between Oct. 15 and Dec. 7th, and as early as possible during this window. This should not be done without the assistance of a knowledgeable agent.
Please contact us, Lee Health Insurance Services, at 925-284-2000 if we can be of assistance.
Phil Lee
About Phil Lee