Friday, March 28, 2014

ACA deadline, explained.

Whenever I feel that the media has done a poor job of explaining something, I decide that I should do research they've failed to do, then explain what was left out.  Therefore, here is a list to explain what the March 31st deadline is, regarding the ACA:

  • The deadline refers to the federal requirement that, to avoid penalties, you must be enrolled in a plan that has been qualified as meeting the minimum requirements of coverage and benefits, for at least 9 months out of a calendar year.  March 31st is the latest date you can meet this enrollment requirement.
  • If you are enrolled before the deadline (during this month), your coverage won't start until May 1.
  • Notice the difference between coverage and enrollment?  The law does not demand that you are covered, but that you are enrolled for 9 months out of the year.
  • This open enrollment period for 2014 ends on all state and federal exchanges on March 31st.
  • You can enroll outside of the open enrollment periods, under certain circumstances.  This is called the special enrollment period, which lasts 60 days following your change in circumstances.
  • Just because you apply does NOT mean that you are enrolled.  Your application must be processed and accepted.  The Obama Administration has offered the promise to allow for extension requests (technically this means you're in a special enrollment period) so long as you had already started the application process by March 31st.  This extra time only extends to mid-April.
  • If you earn too much to qualify for subsidies, you don't need to apply through these exchanges, called Marketplaces.  For instance, in Oregon where the exchange is badly broken, the best option is to apply directly through co-ops, private exchanges, or directly from insurers...after you've used the Cover Oregon website to do a rough estimate of whether or not you might qualify for subsidies, and what kind of plans exist.
  • The penalty for 2014, if you miss this deadline, is zero if your household income is below $10,150; $95 if your income is between $10,150 and $19,650; 1% of your household income is above $19,650, but capped at $285 per household.  These values increase until they reach their maximum in 2016.
  • This penalty applies for EVERY month of the year.  The yearly total -- the prior bullet point figures -- are divided into 12 and applied per month.  If you enroll by March 31, the penalty will be waived for the three months you missed this year -- January, February and March.
  • From here on out, the enrollment periods will be from November 15 to February 15.
  • Medicaid (poverty-level based income levels) and SCHIP (children) programs do not have deadlines, but then again, if you're this poor you should have applied yesterday, not tomorrow.
You can now find the best strategy that applies to you, which probably means getting an application for health insurance in by March 31st.

No comments: