Tag Archives: Special Enrollment Period

Wedding Planning: From Ceremony to New Life

Vantage Point: Wedding Season Brings Many Changes

Summertime is here, which means wedding season has arrived.

Weddings are filled with so much love and anticipation. These magical ceremonies take so many months of planning and preparation, like figuring out the date, color scheme, invitations, venue, photography, bridal shower, and of course, the guest list.

As the special day arrives, you get to see all of the hard work and planning come together. As the day goes on, the happy couple gets together and dances the first dance, enjoys delicious cake, and takes pictures with all the guests.

As you wind down and look into the future, the next phase of planning begins. This is a new life as you are no longer only thinking about yourself but also about your significant other. Many new married couples move into a new home, which means you might have a new address.

Before putting your new last name on the mailbox, you need to officially change your name. The first step is visiting the Social Security Administration office or mailing in an application for a new Social Security card. Once that is complete, the next stop is the Department of Licensing. This will give you a chance to retake that driver’s license picture you probably didn’t like anyway. It will have a new name and your new married smile, plus your new address.

Once you have changed your name with the Social Security Administration and the Department of Licensing, changing your name with other companies should be a breeze. Places to contact would be your employer’s office, credit card companies, banks, and insurance companies. Now that you are married, your insurance options might change. This is a great time to take another look at your current coverage.

Another very important part of this is to update your Power of Attorney (POA). Since you are officially a new couple, you’ll need to complete a new Power of Attorney. With all the changes in your life, you might want to reconsider who your POA is.

It all seems like a lot of paperwork, but once it is complete, you won’t have to think about it anymore. You can put it behind you and start your new beginning.  Then, you can sit back, relax, reminisce about your wonderful wedding day, and look into the bright new future.  

Jessica Arroyo, born and raised in the Wenatchee Valley, is a Medicare community liaison for Health Alliance Northwest, serving Chelan, Douglas, Grant, and Okanogan counties in Washington. During her time off, she enjoys spending time with her husband and infant son.

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.

Shop Online for Health Insurance

New to Shopping for Health Insurance?

If you’ve never shopped for health insurance before, it can be a little scary. We are going to make the journey easier this Open Enrollment Period. Check back each week for another post that helps you shop for a Health Alliance plan.

We’ll start small – with the Open Enrollment Period.

The Open Enrollment Period (OEP) is from November 15 to February 15 this year. Each fall, the government picks a time that you can buy insurance for the next year.

What happens if you don’t enroll by February 15?

You will have to wait until the next Open Enrollment Period (fall of 2016), or have a life-changing event, like getting married or having a baby, that qualifies you for a Special Enrollment Period.

After February 15, most people will have to pay a penalty for not having a plan, and worse yet, they’ll still have to pay for 100%of their medical costs. Talk about adding insult to injury!

Can you change your plan after the OEP?

No, you would have to wait until the 2016 OEP to change plans. If you’re unhappy with your current plan, now is the time to take action!

How does the government know if you have insurance?

They’ll ask you on your taxes. Health insurance companies like Health Alliance will also turn in information to the IRS telling them who has a qualified health plan (QHP) through us.

What’s a Qualified Health Plan?

A Qualified Health Plan (QHP) is a plan that is certified by the federal Health Insurance Marketplace. That means it will include all the benefits the Affordable Care Act (ACA) requires and meets all of the spending limits and rules of the ACA.

Why should you buy health insurance instead of paying the fine?

Sometimes, especially when you’re young and healthy, it seems like paying a one-time fine could be a better deal than paying a monthly insurance premium.

But in that case, you need to weigh the risk with the money. The average hospital stay for people 18 to 44 years old is $7,400.

The average cost of a broken arm for a simple break is $2,500-$3,500. If it was bad break, it can be several times more than that.

Can you afford to pay $2,000 out-of-pocket? What about $10,000? What if you were in an accident or needed surgery, would the cost of taking care of yourself ruin you financially? When you think about it that way, the cost of health insurance is a good investment. Learn more about insurance on our website.

When you’re ready to start shopping, Health Alliance can help you. Visit HealthAlliance.org or call us at 1-877-686-1168 to learn more.

Summer Relaxing with a SEP

What’s So Special About Summer?

Didn’t buy health insurance by the deadline? Had some unexpected changes since then and need a plan, fast? A Special Enrollment Period (SEP) might be right for you. We have just what you need this summer to take a little of that heat off.

Dog Days

  1. Ice Cream
  2. Humidity More Ice Cream
  3. Getting a Special Chance to Buy Health Insurance

Every year, as summer turns to fall, and fall to winter, millions of Americans buy health insurance. During that season, the government gives everyone a chance to buy the plan they need, but by early spring, time’s up!

But here’s some good news, everyone knows the world doesn’t stop turning during the summer months. That’s why some special rules help you out when life gets interesting.

Special Enrollment Periods (SEPs) are special chances to buy or make changes to your health insurance plan the rest of the year. Here’s a quick Q&A on how they work.

Interested in signing up or need to learn more? Give us a call at 1-888-382-9771! We’re here to help.

Q:  What’s an SEP?

A: After March 31, only people with a qualifying life event can change their individual or family plan or enroll in a new plan. That’s called having an SEP.

Q: What’s a qualifying life event?

A: Events include:

  • Getting married
  • Having, adopting, or the placement of a child
  • Permanently moving to a new area with different health plan options
  • Losing other health coverage because
    • You lost your job
    • You don’t work enough hours to stay on your employer’s plan
    • Your employer stops paying for your plan or stops paying as much
    • Your plan doesn’t cover the essential health benefits as required by the Affordable Care Act (ACA)
    • A big increase in how much you pay for your plan

Q: Is a change in my income a qualifying life event?

A: For people who already have a qualified health plan, a change in income or household status can be a qualifying life event. Both of these events might change how much government help you can get to pay for your plan.

Don’t forget, you can apply for Medicaid or the Children’s Health Insurance Program (CHIP) any time.

Q: Why don’t I always qualify for an SEP if I lose my coverage?

A: Some events don’t count as a qualifying event:

  • Losing your plan because you didn’t pay your premiums
  • Choosing on your own to quit other health coverage
  • Losing coverage that’s not minimum essential coverage, like a short-term plan or (in some cases) a catastrophic plan

Q: What if I don’t have a qualifying life event?

A: You have to wait until the next Open Enrollment Period (OEP), which will begin during the fall. The government sets the start and end dates of OEP, not Health Alliance.

You can enroll in a Short-Term plan at any time. But remember, they don’t meet the requirements of the ACA for being a qualified health plan, which means you’ll have to pay a tax penalty in 2015.

Q: How long do I have to enroll in a plan after a qualifying event?

A: 60 days.

Q: How do I enroll?

A: You get to choose how you’d like to enroll. Find what works best for you, and if you need help along the way, call us at 1-888-382-9771. Or if you’re in the Champaign area, stop by our office at 206 W. Anthony Drive (near Alexander’s Steakhouse) for help!

Q: When will my coverage start?

A: Your start date depends on your qualifying event.

If you have questions about an SEP or about your situation, give us a call at 1-888-382-9771 or stop by our office—we’re more than happy to help you find the answers.

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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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