The document discusses consequences for missing the open enrollment period for health insurance through Covered California in 2016. It notes that penalties for being uninsured in 2015 will increase substantially. However, people may still be able to enroll outside of open enrollment if they experience a qualifying life event, such as getting married, having a baby, moving, or losing other health coverage. These special enrollment periods allow people to sign up without penalty. The document provides more details on qualifying life events and explains that people may also be eligible for free or low-cost coverage through Medicaid or other state programs regardless of their qualifying life event.

1. What Happens If I Miss
the Open Enrollment
Period for 2016?

2. You Still Have Time
While it may be premature to worry about missing the upcoming open
enrollment period for 2016, it may be good to know the consequences. In
2016, the penalty for not having health insurance in 2015 will increase
substantially from the fine levied for the failure to obtain coverage in 2014.
In fact, you could be looking at putting a major dent in your wallet by
paying $695 for an uninsured adult, and up to $2,085 per household or 2.5
percent of your income – whichever is greater. However, all is not lost. You
may be able to enroll in coverage outside the normal Covered
California open-enrollment period, if you experienced what is considered a
“qualifying life event”.
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3. Depending on your circumstance, there are a
number of different legitimate life events
under the Affordable Care Act and Covered
California www.coveredca.com that could
give you a reprieve and make you eligible for
special enrollment.
You Still Have Time
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4. • Getting married
• Having a baby
• Adopting a child or placing a child for adoption
or foster care
• Losing other health coverage
• Moving to a new permanent residence
• Gaining citizenship or lawful presence in the
U.S.
• Leaving incarceration
• Delay in having a divorce finalized
• For people already enrolled in Marketplace
coverage:
o A change in income or household status that
directly affects eligibility for premium tax credits or
cost-sharing reductions
o Important: Quitting your Marketplace plan
voluntarily mid-year doesn’t make you eligible for a
Special Enrollment Period.
Life events that may qualify you for a
Special Enrollment outside the open
enrollment period include, but are not
limited to:
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5. Special Enrollment Qualifications
You could also qualify for a special enrollment with other life events, such as losing
your employer-sponsored insurance plan, but this may require contacting your
insurance plan’s customer service to discuss the matter for further evaluation.
Don’t wait until you’re sure to get a fine for not obtaining some sort of health
coverage. If you’ve had any change in your plan or you’ve experienced a life event,
contact Covered California or a Freeway Insurance agent as soon as possible to
discuss your options.
If you’re lucky enough to qualify, applying for health coverage through the special
enrollment isn’t much different from the normal open-enrollment period. You’ll
choose the Covered California health insurance plan that works best for you – and,
better yet – you won’t have to worry about paying a penalty for not having health
insurance.
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6. However, should none of the qualifying life events
listed apply, the good news is – you may still be eligible
for health care through Medi-Cal or California’s Access
for Infants and Mothers (AIM) program for pregnant
women. These plans include the same 10 essential
health benefits as the Covered California plans. Of
course, eligibility for these programs is based on your
income and your application will be reviewed for
coverage through Medi-Cal and AIM – no matter which
life event you select.
In the end, citizenship and residency status, typically,
will decide eligibility. And, if you don’t meet Medi-Cal’s
requirements, there are optional plans offered by
Covered California for immigrants to choose from.
However, health insurance for undocumented
immigrants may still be a possibility under certain
circumstances, though on a limited scale.
Special Enrollment
Qualifications
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7. Special Enrollment Qualifications
Freeway Insurance, the premier healthcare insurance broker, is partnering with
Covered California and some of the nation’s most trusted carriers to help those
following a qualifying life event obtain health insurance. Freeway’s services to find
you the best health insurance quote and guide you through the confusing sign-up
process are 100% free.
Why not speak with a Freeway Insurance professional about special enrollment or
to sign-up for the first time? Cover all your bases so you can avoid paying a fine for
missing Covered California’s open enrollment 2016.
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8. Did you miss last year’s open
enrollment period? Feel free to share
your thoughts in the comments
section below.
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