Special Enrollment – NCHealthPlans.com Health News

Temporary Health Insurance – A Great Solution

Kristen Baily — Mon, 15 Feb 2016 17:23:47 +0000

Being 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!

Temporary health insurance is one of the best ways to keep your family covered in times of transition and change. Maybe you are recent college graduate or are working a temporary or part time job. Maybe you are looking to bridge the gap until you become eligible for Medicare. If so, Short Term coverage is a fast, affordable and easy solution and we are pleased to offer you a variety of plans.

With these Short Term Plans, you have access to a nationwide network of doctors and hospitals offering you great value and great service. You will receive quality care at a significant discount with a network of providers who have agreed to lower fees for covered expenses. You can receive care from any doctor or hospital in the network and with many different short term plans available, you have the freedom to choose the amount of coverage you need for the amount of time you need, from 1 to 11 months. With additional supplemental benefits available, you can also customize your insurance coverage to meet your specific needs.

Keep in mind there are limitations to Short Term health plans. There is no coverage for preexisting conditions, meaning not everyone will qualify, and these plans do not offer the mandated coverage necessary to keep you from paying a tax penalty under the Affordable Care Act. Nonetheless, these plans can be a temporary solution to your health insurance needs.

For more information, 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.

Can I Enroll in Health Insurance? – Understanding Special Enrollment

Kristen Baily — Thu, 10 Sep 2015 15:50:53 +0000

By 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. 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, which begins November 1, 2015 and runs through January 31, 2016. If you enroll during Open Enrollment, your health plan will not become effective until January 1, 2015 or later depending on the date of your application. Keep in mind, 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. For uninsured individuals without a QLE, temporary insurance is a smart option while you wait.

For others, a Qualifying Life Event may have occurred in which case you may be eligible to enroll in health insurance now. A Qualifying Life Event is a specific circumstance that has altered your life and created an opportunity for you to enroll in health coverage—and there are strict guidelines to determine exactly what qualifies. For example, a recent marriage, adoption, 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 a move to North Carolina or a move to a different county within North Carolina. 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.

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 or make changes to your existing policy. 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.

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

Kristen Baily — Mon, 03 Aug 2015 18:00:35 +0000

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? Again, the answer is yes. Having access to group coverage does not disqualify you from pursuing other insurance options. In fact, enrollment in any non-calendar year group health plan is now a Qualifying Life Event.

Recently the Healthcare Marketplace extended the list of Qualifying Life Events (QLE’s), allowing more individuals to enroll in health coverage outside of Open Enrollment. Under the ACA, a person must have experienced one of these QLE’s within the last 60 days in order to be qualified for a Special Enrollment Period, and now that list includes the enrollment periods for certain group health plans. For instance, if your company or business offers you health insurance, during your company’s open enrollment period you will have a valid Qualifying Life Event and can at that time decide to either stay with group coverage or enroll in an individual health plan. Keep in mind, however, you only have 60 days to complete the enrollment process if you are opting out of group coverage.

Also, be aware that although you will have a Qualifying Life Event, you may not qualify for a federal subsidy. Having access to affordable group coverage as defined by the Healthcare Marketplace can disqualify you from receiving a premium tax credit to help you pay for your health insurance. Keep in mind, however, that although you may not receive a federal subsidy oftentimes individual health plans are still more affordable, especially for family members. If your company has an open enrollment period, it may be a good time to explore other options. An individual Blue Cross Blue Shield of NC health plan could be the perfect fit!

For you or your dependents under the age of 30, for example, you can save money with a Blue Cross Blue Shield of NC Catastrophic plan. Or, you may be able to get more coverage for your dollar simply because every BCBSNC health plan includes pediatric dental and vision as an added benefit. For these and other reasons, an individual health plan could be a wiser investment than group coverage and with the expansion of the list of QLE’s, it pays to do the research.

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.

Need Health Insurance Now? – Get Short Term Coverage

Kristen Baily — Thu, 30 Jul 2015 16:08:37 +0000

For more information on Blue Cross Blue Shield of North Carolina 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.

A Baby Changes Everything – BCBSNC Coverage for new Dependents

Kristen Baily — Fri, 24 Jul 2015 14:26:39 +0000

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. The good news is that welcoming a new child into your family through either birth or adoption qualifies you for a Special Enrollment Period, meaning you do not have to wait until Open Enrollment begins in November to enroll your new dependent in a health plan.

In fact, you have 60 days from the day your baby is born or the day of your adoption to sign up for health insurance.If you are currently enrolled in a health plan, having a baby allows you the opportunity to add your baby to your current plan and make any other necessary changes to your coverage. Keep in mind, that all ACA approved health plans now include maternity and newborn care as part of the 10 Essential Health Benefits and that newborn care can make a big difference in your baby’s overall health and wellness.

In fact, pediatricians now recommend getting your new baby onto a wellness program as soon as he or she is born and keeping your child on that program throughout their young lives. This will ensure that your baby’s immunizations, growth, and developmental milestones are all right on track.

If you know you are expecting a baby, start your research now. You can generate a quote to purchase your new baby a Blue Cross Blue Shield of NC individual health plan or see what it will cost to add your newborn to your existing health plan. Keep in mind that when you enroll your new dependent in a BCBSNC health plan, your baby’s insurance coverage will be retroactive to the date of birth.

Having a baby is a wonderful and exciting experience, but also full of big life changes. Make sure your baby’s health care needs are fully covered so that you can give your child the best start possible.

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

Kristen Baily — Thu, 11 Jun 2015 12:27:27 +0000

By 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.

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

Kristen Baily — Fri, 24 Apr 2015 15:36:24 +0000

The 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!

Suprised by Tax Penalties? – CMS Offers Special Enrollment Period

Kristen Baily — Fri, 13 Mar 2015 15:27:19 +0000

For 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

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

Kristen Baily — Tue, 03 Mar 2015 14:08:37 +0000

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.

You May Still Be Able to Enroll – Marketplace Grants Extension

Kristen Baily — Wed, 18 Feb 2015 21:20:38 +0000

The 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.