NCHealthPlans.com Health News » Special Enrollment

Home  |  About Us  |  Terms of Use  |  Contact  

Jerry Ballard & Associates, Inc.
Local: 252-726-5400
Toll Free: 888-765-5400


A name you can trust, an agent you can count on.
Serving North Carolina residents since 1974.

NC Health Plans

Posts Tagged ‘Special Enrollment’

Temporary Health Insurance – A Great Solution

Monday, February 15th, 2016

Fill the Gap words on a puzzle piece ready to be placed in a holBeing uninsured is never wise, but let’s face it.  Life happens and sometimes you find yourself in a situation where you are experiencing a gap in coverage and need insurance now.  Perhaps you are transitioning from one job to another and there are a few months in between when coverage is not available to you through an employer.  Or perhaps you missed Open Enrollment and now find yourself without a Qualifying Life Event that allows you to enroll in health coverage during Special Enrollment. Whatever the case, you are not out of options.  Short Term coverage can help fill that gap and it is available to you as soon as the very next day! (more…)

Can I Enroll in Health Insurance? – Understanding Special Enrollment

Thursday, September 10th, 2015

Student thinking with question marks on blackboard. Asian femaleBy now, most of us have heard the terminology, but what exactly is a Special Enrollment and what constitutes a Qualifying Life Event?

Under the Affordable Care Act, there are two different periods in which an individual may apply for health insurance.  The first is referred to as Open Enrollment and during this time any person may apply for health coverage for any reason, as well as make changes to any existing health insurance policy.  During Special Enrollment, however, there are more restrictions and a person is required to have what is referred to as a Qualifying Life Event (QLE) in order to acquire health insurance.  (more…)

Want to Opt out of Group Insurance? – Now you Can!

Monday, August 3rd, 2015

Everyday Winner.One of the major concerns for Americans with the initiation of the Affordable Care Act was whether or not individuals would be able to stay with their employer’s group plan if they so desired.  The answer is yes.  The ACA did not mandate individual coverage versus group coverage, but simply mandated minimum essential coverage for every individual.  Oftentimes, that coverage can be obtained through an employer or a group health plan.

However, with the rise in the cost of insurance, many Americans are now asking the opposite question:  must I continue with my group coverage or can I pursue a more affordable individual option for either myself or my family members?  (more…)

Need Health Insurance Now? – Get Short Term Coverage

Thursday, July 30th, 2015

Fill the Gap words on a puzzle piece ready to be placed in a holBeing uninsured is never wise, but let’s face it.  Life happens and sometimes you find yourself in a situation where you are experiencing a gap in coverage and need insurance now.  Perhaps you are transitioning from one job to another and there are a few months in between when coverage is not available to you through an employer.  Or perhaps you missed Open Enrollment and now find yourself without a Qualifying Life Event that allows you to enroll in health coverage during Special Enrollment. Whatever the case, you are not out of options.  Short Term coverage can help fill that gap and it is available to you as soon as the very next day! (more…)

A Baby Changes Everything – BCBSNC Coverage for new Dependents

Friday, July 24th, 2015

For anyone who’s ever had a baby or anyone who is expecting to have a baby, you know all too well.  A baby changes everything!  There are so many new things to think about and determining the proper amount of health coverage for your new bundle of joy is one of the most important.  (more…)

Get BCBSNC Insurance during SEP – Federal Marketplace Extends List of Qualifying Life Events

Thursday, June 11th, 2015

Health InsuranceBy now, most Americans are aware of the changes instituted by the Affordable Care Act and the impact this law has had on health insurance.  Terms like “premium tax credit,” “federal subsidy,” “Health Insurance Marketplace,” and “individual mandate,” however, are still often unfamiliar to consumers now navigating a system reorganized under completely different criteria and governed by federal law.  Understanding the new terminology is paramount in understanding much of what constitutes the Affordable Care Act and is a key part of being able to successfully choose, enroll and manage a health insurance policy.

That being said, perhaps one of the most confusing aspects of the Affordable Care Act is the Special Enrollment Period and why you must have a Qualifying Life Event in order to enroll in health coverage.  Prior to the Affordable Care Act, consumers had the benefit of enrolling in individual health insurance or making changes to their existing policies at any time during the year.  On the flip side, insurers had the right to practice medical underwriting and charge more for, or deny coverage to, consumers who had serious or preexisting health conditions.  Under the new law, these conditions have changed.  Insurers may no longer ask consumers any health questions (with the exception of whether or not you are a smoker) and no consumer can be denied health insurance based on a preexisting condition; however, consumers may not enroll or make changes to their health policies whenever they choose, but are now subject to the rules of Open Enrollment, Special Enrollment and Qualifying Life Events (QLE’s).

For 2015, Open Enrollment will begin November 1st and end January 31st.  During Open Enrollment, you may purchase health insurance or make changes to your current policy for any reason.  Currently, however, we are in the Special Enrollment period, which means consumers are required by law to have a Qualifying Life Event in order to purchase insurance.  A Qualifying Life Event is some special circumstance, such as a recent move or the loss of access to minimum essential coverage, that allows the consumer to purchase insurance outside of Open Enrollment.  Although this does limit your ability to enroll in health coverage, the good news for 2015 is that the list of Qualifying Life Events has been expanded and the Healthcare Marketplace is offering more opportunities for consumers to get insured during Special Enrollment.

In order to determine whether or not you may have a Qualifying Life Event, it is important for you to take a look at the list provided on your Blue Cross Blue Shield of North Carolina health quote.  Reading the list of QLE’s will help you to determine if one of these special circumstances applies to you.  Although the process of obtaining health insurance has changed under the ACA, the expansion of these QLE’s allows you greater freedom outside of Open Enrollment to manage your current health plan or enroll a new health plan according to your life circumstances.

For more information on Blue Cross Blue Shield of North Carolina health insurance coverage, the Marketplace and healthcare gov  to apply for your subsidy, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents.  Let us help you navigate through the Health Care Reform changes in accordance with the new regulations of The Affordable Care Act, also known as Obama care.

 

 

 

Last Chance for 2015 – Federal Marketplace SEP Ending April 30th

Friday, April 24th, 2015

last chance or opportunity time on clock is ticking away now orThe Special Enrollment Period the federal Marketplace granted for those individuals who did not meet the February 15th deadline for Open Enrollment is ending April 30th.  This could be your last chance to enroll in a health insurance policy until January, 2016.  This Special Enrollment Period is not for everyone, but if it applies to you, you could have one last opportunity to get insured.

In an effort to enroll as many Americans as possible, the federal government installed this Special Enrollment Period for people who meet the following three criteria:  1) you were not insured in 2014; 2) you had to pay a tax penalty when you filed your 2014 taxes; 3) you will attest to the fact that you were unaware of the tax penalty or did not fully understand the implications of that penalty.  If these criteria apply to you, you have 6 more days to complete an application for health insurance with the federal Marketplace.  Keep in mind, your application must be completed and submitted by midnight April 30th, meaning you have selected a health plan and your application has been sent to Blue Cross Blue Shield of NC.  Depending on your effective date, however, you may still have a period of time before you will need to make your first premium payment.

Once this Special Enrollment Period ends, your opportunity to enroll in health insurance becomes much more limited.  Under the rules of the Affordable Care Act, for the remainder of 2015 you will need to have a Qualifying Life Event in order to purchase health insurance.  If you do not have a Qualifying Life Event, you will have to wait until Open Enrollment 2016 begins in November and you will not have health coverage until January 2016.  Also, don’t forget that the tax penalty, sometimes called the “individual mandate,” for being uninsured is increasing in 2015 and instead of paying $95 per person or 1% of your household income (whichever is greater), next year you will pay $325 per person or 2% of your household income (whichever is greater).  The tax penalty will increase again for 2016.

The bottom line is it doesn’t pay to be uninsured.  Not only are you running the risk of incurring potentially devastating health care bills, you are also not able to maintain your health and wellness through regular preventive care physicals and health maintenance.  If you are one of the many Americans who are still able to enroll in health coverage under the Special Enrollment Period ending April 30th, take advantage of this opportunity to get insured!  Instead of throwing money away on tax penalties, make an investment in your wellness and peace of mind.  Blue Cross Blue Shield of North Carolina is pleased to provide the residents of NC with quality health coverage at a competitive price.  Don’t wait another minute!

For more information on Blue Cross Blue Shield of North Carolina health insurance coverage, the Marketplace and healthcare gov  to apply for your subsidy, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents.  Let us help you navigate through the Health Care Reform changes in accordance with the new regulations of The Affordable Care Act, also known as Obama care.

 

 

 

 

 

Suprised by Tax Penalties? – CMS Offers Special Enrollment Period

Friday, March 13th, 2015

Shocked male office workerFor individuals and families who did not have health coverage in 2014 and are subject to the tax penalty when they file 2014 taxes, a special enrollment period (SEP) has been announced.  This SEP has been created for those individuals who were unaware of the tax penalty or failed to fully understand the implications of the penalty for not enrolling in coverage during 2014.  From March 15th to April 30th, CMS is providing consumers with another opportunity to purchase health insurance; however, if consumers do not purchase during this enrollment period, they may have to pay the penalty when they file their 2015 income taxes.

The special enrollment period will begin on March 15, 2015 and will end at midnight Eastern Standard Time on April 30, 2015.  If a consumer enrolls in coverage before the 15th of April, coverage will begin on May 1st and if a consumer enrolls between April 16th and April 30th, coverage will begin on June 1st.

Because this year’s tax season is the first time individuals and families are required to provide information about their health coverage on their tax returns, CMS recognizes that there may be an adjustment period.  Administrator Marilyn Tavenner stated regarding this special enrollment period, “Our priority is to… provide those who were not aware or did not understand the requirement with an opportunity to enroll in affordable health coverage this year.” Further, those who could not afford coverage or met other certain conditions may be eligible to receive an exemption from the tax penalty.

The majority of taxpayers will only be required to indicate on their tax return that they had health coverage in 2014, either through an employer, Medicare, Medicaid, or other health coverage that meets the requirements of minimal essential coverage.  Other taxpayers will be granted an exemption from the tax penalty and still other taxpayers will pay a penalty for choosing to remain uninsured.  Americans who do not qualify for an exemption and who are required to pay the penalty will be paying a fine of $95 per adult or 1% of their income, whichever is greater.  This special enrollment period is designed to allow such individuals one final opportunity to get coverage and avoid having to pay other penalties in 2015.

Those eligible for this special enrollment period must meet ALL of the following requirements:

  • Live in states with a Federally-facilitated Marketplace
  • Attest that when they filed their 2014 tax return they paid the tax penalty for not having coverage
  • Attest that they first became aware of, or understood the implications of, the Federal Tax Penalty after the end of Open Enrollment

For more information on Blue Cross Blue Shield of North Carolina health insurance coverage, the Marketplace and healthcare gov  to apply for your subsidy, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents.  Let us help you navigate through the Health Care Reform changes in accordance with the new regulations of The Affordable Care Act, also known as Obama care.

All information contained herein is subject to change, from time to time, if the Federal Government or Blue Cross Blue Shield of North Carolina implement any new updates and/or changes that can impact information provided in this blog.

Can I Purchase Health Insurance Now? – Understanding Special Enrollment

Tuesday, March 3rd, 2015

bigstockphoto_teens_with_thumbs_up_6006256

 

Open Enrollment 2018 has officially ended and the Special Enrollment Period has begun.  Contrary to what so many people believe, this does not mean that no Americans are able to purchase health insurance.  It simply means that those purchasing or making changes to existing health insurance plans are subject to a different set of rules that apply to the Special Enrollment Period.

The most distinguishing factor of Special Enrollment is that in order to purchase or change a health insurance plan you must have what is called a Qualifying Life Event.  This means you must have a special circumstance in your life that would qualify you to purchase or change insurance outside of Open Enrollment.  People often experience Qualifying Life Events without even realizing the opportunities presented as it relates to health insurance.

 

The following is a list of common Qualifying Life Events:

  • Loss of minimum coverage (through an employer, government plans, Medicaid, etc.)
  • Adding a dependent through birth, adoption or marriage
  • Gaining United States citizenship
  • Enrollment/non-enrollment errors by the federal Marketplace or the United States Department of Health and Human Services
  • Newly eligible for a subsidy or a change in the amount of subsidy for which you are eligible
  • Move to North Carolina or a new county within North Carolina
  • Other exceptional circumstances

Although this is a list of a few qualifying life events, this list is not exhaustive.  Ultimately, the only way to really determine if you are eligible to change or purchase health insurance during Special Enrollment is to complete an application.  Keep in mind that you can apply for health insurance without any obligation to purchase and the application itself will help you determine subsidy eligibility.

For more information on Blue Cross Blue Shield of North Carolina health insurance coverage, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents.  Let us help you navigate through the Health Care Reform changes in accordance with the existing regulations of The Affordable Care Act, also known as Obama care.

All information contained herein is subject to change, from time to time, if the Federal Government or Blue Cross Blue Shield of North Carolina implement any new updates and/or changes that can impact information provided in this blog.

 

 

You May Still Be Able to Enroll – Marketplace Grants Extension

Wednesday, February 18th, 2015

last chance or opportunity time on clock is ticking away now orThe Health Insurance Marketplace has announced that despite the fact Open Enrollment ended at midnight, February 15th, you may still be able to obtain health insurance for 2015.  The Insurance Marketplace is granting this extension for anyone who missed the deadline due to either technical issues or unusual call volume that made it impossible for you to complete your application by the deadline.  A Special Enrollment Period has been set for February 16-February 22 by the federal government for all those who may have had trouble on the government website or experienced an extensive Call Center wait on February 13, 14 or 15.

This Special Enrollment Period may apply to you:

1.  if you tried to enroll in health coverage by the deadline, but did not complete the enrollment process because of unusual wait times at the Call Center or…

2.  if you tried to enroll, but were unable to complete enrollment due to a technical issue, such as being unable to submit your application because verification sources were down.

If either of these apply to you, you may still be able to get coverage.  To finish your enrollment, you must attest to the truth of one of the above statements with the federal Marketplace and this opportunity will only be available until February 22. 2015.  In order to determine if you eligible for this Special Enrollment Period, you should contact the Marketplace directly.  If you do determine you are still eligible to enroll, we would be happy to help you pick your Blue Cross Blue Shield of NC health plan and guide you through the steps to complete the enrollment process.

Please note that this Special Enrollment Period is intended to help consumers enroll for 2015 health insurance for the first time.  It is not applicable for customers who are already enrolled in a plan through the Marketplace and simply want to switch to a different plan now.  Changes to your health insurance policy are now subject to the rules of Special Enrollment including Qualifying Life Events.

For more information on Blue Cross Blue Shield of North Carolina health insurance coverage, the Marketplace and healthcare gov  to apply for your subsidy, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents.  Let us help you navigate through the Health Care Reform changes in accordance with the new regulations of The Affordable Care Act, also known as Obama care.

What Constitutes a Qualifying Life Event?

Monday, September 15th, 2014

bigstockphoto___155599Negotiating new terminology is one of the toughest parts to understanding all the recent changes in health care policies and procedures.  Terms like “open enrollment,” government subsidies,” and “qualifying life event (QLE)” can be confusing even to the most thorough students of health insurance and the Affordable Care Act.  When applying for health coverage, however, understanding these terms and how they can affect your health care options is an absolute imperative.

Under the Affordable Care Act, there are two different periods in which an individual may apply for health insurance.  The first is referred to as Open Enrollment and during this time any person may apply for health coverage.  During Special Enrollment, however, there are more restrictions and a person is required to have what is referred to as a Qualifying Life Event (QLE) in order to acquire health insurance.  If you do not have one of these Qualifying Life Events, you may not purchase health insurance during Special Enrollment and must wait until the Open Enrollment Period.  This is not a Blue Cross Blue Shield of North Carolina policy, but rather a policy of the federal government under the Affordable Care Act with which BCBSNC must comply.

Basically, a Qualifying Life Event is a specific circumstance that has altered your life—and there are strict guidelines to determine exactly what qualifies.  For example, a recent  marriage, divorce or birth of a child are all events that would make you eligible to enroll in health coverage during a Special Enrollment period, so long as you enroll within 60 days of that life altering event.  Losing previously held health insurance involuntarily is another example of a Qualifying Life Event, as is changing your permanent place of residence. If your income increases so that you are no longer eligible for Medicaid, you are also able to enroll in new coverage during a Special Enrollment Period.  Because the list of Qualifying Life Events is so varied, however, it is worth investigating whether you qualify to enroll during a Special Enrollment period.

Although the terminology can be confusing, it is important for you to understand what constitutes a Qualifying Life Event because it can have a huge impact on your ability to purchase health insurance.  In addition, the effective date of your coverage will depend on your QLE and the date of your application.

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). It would be our pleasure to help you navigate through the Health Care Reform changes in accordance with the new regulations of Obamacare. Call us for details.

 

Special Enrollment Period Qualifications Set by ACA

Monday, March 3rd, 2014

bigstockphoto_puzzled_question_75542Call today and go over questions about Open Enrollment vs Special Enrollment so you do not lose the opportunity to acquire coverage.  To enroll in a Blue Cross Blue Shield of North Carolina health plan, outside of the annual enrollment period, you must qualify under the Special Enrollment guidelines set out below.  Special circumstances for enrolling outside of the open enrollment period include:

Loss of minimum coverage (employer coverage, government plans, etc.)

Adding a dependent through birth

Adoption or marriage

Gaining citizenshipEnrollment/non-enrollment errors by the federal Marketplace or the US Department of Health and Human Services

Qualified health plan violates the material provision of its contract with the individual

Newly eligible for a subsidy or a change in the amount of subsidy you are eligible for

Moving to a new state

American Indian/Alaska Native status (may change once a month)Other exceptional circumstances

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). It would be our pleasure to help you navigate through the Health Care Reform changes in accordance with the new regulations of Obama care. Call us for details.