Did You Miss Open Enrollment for an Individual Health Plan?

Date: April 29, 2014

Here’s what you need to know now.

Obamacare's health insurance open enrollment deadline was March 31, 2014. And open enrollment doesn't come around again until November 15, 2014. If you missed the deadline and are without health insurance, read our Q&A on how to get covered now.

Q: I missed the Affordable Care Act (ACA) open enrollment. Is there any way for me to get health insurance now?

A: Yes, no and maybe. Yes: If you have a Qualifying Life Event (QLE), which will will explain more in the next question below. No: If you don't have a QLE. Maybe: If you purchase a non-ACA plan.

Q: What's a Qualifying Life Event (QLE) and how do I qualify for one?

A: These are events that give people the opportunity to enroll for health insurance outside of open enrollment. Some examples of QLE's are:

  • Renewal of grandfathered or non-grandfathered plan
  • Discontinuation of a current plan that does not meet ACA requirements
  • Move to a new state
  • Marriage
  • Divorce
  • Child birth or adoption
  • Legal separation
  • Change in dependent status as a result of turning age 26
  • Loss of employer-sponsored (group) coverage

Q: What are non-ACA plans?

A: Plans that do not meet ACA requirements can be enrolled in at anytime of the year without a QLE. These plans offer very comprehensive coverage with many different deductible options, some less than ACA plans. These plans are underwritten and do not pay for preexisting conditions, but they typically cost 50 percent less than ACA-compliant plans. Some people simply can't afford an ACA plan (especially those who were not subsidized) but still need health insurance coverage.

Q: Why are people switching from group to individual insurance plans?

A: Small-group (i.e., employer-sponsored) premiums are currently priced much higher than individual plans on and off the exchange. Since January 1, many group plans have been moved over to individual plans due to:

  • Lower price, in most cases
  • Employees may receive subsidies that they cannot under group insurance
  • Fewer requirements than group insurance
  • Employees do not have to agree on the same plan
  • Employer may or may not contribute to the employee plan (Defined Contribution)
  • Premiums may still be tax deductible
  • Terminating a group plan is a QLE

Q: What plans do you have that I can look at and enroll in?

A: We currently have available every ACA plan on the federal exchange, plus many others that are not available through the exchanges (i.e., off-exchange plans). Compare and decide for yourself with our simple one-stop shopping online platform.

Q: How do I find out what I can qualify for?

A: Call 888-488-6266 and speak with a licensed ACA exchange adviser through NFIB’s Health Exchange. The advice is free, so why not take advantage of it? Or visit NFIB's online Health Insurance Exchange.

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