Tag Archives: marriage

SEP Changes like Moving

When Change Happens, We Can Help

Things change. We understand that the unexpected is a part of life. But there are ways we can help you get covered when the unexpected happens.

If you weren’t able to get coverage during this Annual Enrollment Period, or if something important has changed and you need a new plan, you may be able to get a Special Enrollment Period (SEP).

During an SEP, you can buy a new plan or make changes to your current plan.

To get an SEP, you need a qualifying life event (something that has changed your insurance needs). Qualifying life events include:

  • Getting Married
  • Having, adopting, or the placement of a child
  • Permanently moving to a new area offering different health plan options
  • A change in income or household status, which can change how much government help you can get
  • Losing other health coverage because of:
    • Job loss
    • Divorce
    • Loss of eligibility for Medicaid or the Children’s Health Insurance Program (CHIP)
    • Expiration of COBRA coverage
    • Your health plan no longer meets the requirements of the Affordable Care Act (ACA)
    • Reduction or termination of employer contributions
    • Significant increase in the cost of your plan

If any of these items describes your situation, you have 60 days after that event to enroll in a new plan. You can shop with us online or call us at 1-877-686-1168 for help finding a plan.

Your new coverage date will depend on the kind of life event you had and what day of the month you enroll. Learn more about when your new plan will start.

Losing your coverage doesn’t always mean you get an SEP. You can’t get one if you lose your insurance because:

    • You didn’t pay your premiums
    • You chose on your own to quit your other health coverage
    • You lost a short-term plan or (in some cases) a Catastrophic plan

If you can’t get an SEP, you can always get covered with a short-term plan at any time. While they do help with your health costs, they aren’t qualified health plans under the ACA, which means you could still have to pay a tax penalty in the next year.

Still not sure what to do in your situation? Call us at 1-877-686-1168 for help figuring out your options.

Don't Miss Your Deadline!

The End is Near: March 31, 2014

NPHIt’s crunch time, and tomorrow may be too late. We know you understand the definition of a deadline, but what happens if you miss March 31? In short, nothing good!

Let’s run through a few questions you might have about what this deadline really means and why waiting might mean less money in your bank account.

What happens if I don’t enroll in a plan by March 31?

After the deadline, an individual can no longer enroll in a plan. You’d have to:

  • Wait until the next Open Enrollment Period (in Fall 2015)
  • Qualify for a Special Enrollment Period (for example, marriage or the birth of a child).

On top of that, you have to pay a tax penalty. And that doesn’t mean you’re covered, you’ll still have to pay 100% of your medical costs!

If I wait until the end of March to enroll, will I have to pay the tax penalty? I’ve heard if my gap in coverage is more than 3 months, I still have to pay.

As long as you’ve completed the application process by March 31, an exemption will keep you from having to pay a penalty on your 2015 tax returns.If you want to learn more about this exemption, visit the CMS’s Enrollment Period FAQ.

Does enrolling in a Short-Term plan save me from the tax penalty?

No. Individuals on short-term plans will pay the penalty on their 2015 tax return (unless they meet an exemption).

Can I change my plan after March 31?

No. You’ll have to wait until the 2015 Open Enrollment Period to make changes to your plan.

The only exception to this rule is adding a newborn. You have about a month to add your new little bundle of joy to your plan.

You can cancel your plan at any time, but depending how long you go without coverage, you may have to pay a penalty.

How will the government really know whether I have insurance?

Great question. When you submit your federal taxes in 2015, the forms will have a new question about health insurance coverage. Health insurance companies, like Health Alliance, will also have to send the IRS info about who has a coverage with us.

You still have time to enroll in a plan.  And we’re here to help you find one that fits your needs (yes, even if it’s in the last 10 minutes!)

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