ACA OEP Archives - EZ.Insure

Health Insurance Open Enrollment FAQ

The Open Enrollment Period for health insurance is a very important time, when you can change or enroll in a health insurance plan for coverage beginning the following year. It runs from November 1 to December 15, and is the only time during the year when you can purchase a plan, unless you qualify for a Special Enrollment Period. To better prepare you for the Open Enrollment Period, including what to expect and how to find a great plan, we’ve answered some FAQ below.

When Is The Annual Open Enrollment Period?

calendar with the date on november 1 — *Health insurance Open Enrollment begins on November 1st every year.*

The Open Enrollment Period is the one time of the year that you can buy or change your health insurance; if you do not buy health insurance during the Open Enrollment Period, you will have to wait until the following year to do so, unless you experience a qualifying life event.

The Federal Open Enrollment Period starts on November 1st and ends December 15, which gives you just about six weeks to choose a health insurance plan and sign up for one. However, some states have permanently extended their Open Enrollment Period until January 15th or 31st, with coverage beginning February 1st.

Am I Eligible To Enroll In Marketplace Health Insurance?

To be eligible to enroll in ACA Marketplace health insurance, you must:

Be between the ages of 18 and 64
Live in the United States
Be a U.S. citizen
Not currently be incarcerated

envelope in a blue circle — Be sure to review the ANOC letter you will receive about your current plan’s coverage for next year.

What Changes Can I Make During Open Enrollment?

If you currently have a health insurance plan, you will receive an annual notice of change (ANOC) letter in the mail prior to Open Enrollment; you’ll need to carefully review this because there might be changes being made to the price or coverage of your plan. But if your plan is not changing and you are happy with it, you will be automatically re-enrolled for next year.

If you are unhappy with your health insurance plan, you can switch to a new one, but you will have to review all of the plans in your area, including new ones that might have been added. If you don’t review plans in your area during the Open Enrollment Period, you won’t know if there is a better plan for you; the best way to do this is by working with one of EZ’s licensed local agents, who can compare plans easily for you in minutes.

What If I Miss The Open Enrollment Period?

If you miss the Open Enrollment Period, your choices will be very limited until next year’s Open Enrollment Period, unless you qualify for a Special Enrollment Period. To qualify for a Special Enrollment Period (SEP), you’ll need to have experienced one of the following qualifying life events:

Getting married or divorced
Death of a spouse or policyholder
The birth or adoption of a child
Loss of health insurance coverage
Moving to a new area where the health plans are different from what you currently have

If you are looking for health insurance temporarily until the next Open Enrollment Period, you have the option of short-term health insurance, which will cover you for up to 36 months, but this type of plan has limited coverage.

Can I Afford Health Insurance?

The first thing you should do if you’re looking to save money is work with an agent who can compare plans for you and find one that fits your budget. Next, check to see if you qualify for subsidies, such as premium tax credits and cost-sharing subsidies. Premium subsidies are available in every state, and help make health insurance more affordable. Eligibility for subsidies is based on your household income; it’s definitely worth checking to see if you qualify, since President Biden recently extended premium subsidies to millions of Americans, making them easier to get, even for those with an income of 400% of the federal poverty level or higher.

How Do I Find A Plan?

If you have any further questions, or need help finding a plan during the Open Enrollment Period, an EZ agent can help you. We will provide you with a local licensed agent who will search all available plans in your area and find the best one for your medical and financial needs. We will also double check to see if you qualify for any subsidies to save you even more money. All of our services are done in minutes and at no cost to you. To get free instant quotes, simply enter your zip code in the bar above, or to speak to a local license agent call 888-350-1890.

How To Switch Plans During The Open Enrollment Period

Not happy with your health insurance plan? Looking to make a change during this year’s Open Enrollment Period? Well, now is the time to make the switch to a plan that better suits your needs – you only have from November 1st to December 15th to do so! But we get it, health insurance can be complicated and it can be confusing trying to figure out which plan to choose: there are so many plans from so many different insurance carriers, so you might not even know where to begin. So to make the process easier for you, we’ve laid out what to look for and how to execute the switch.

Reasons To Switch Plans

There are a number of reasons why you might want to switch plans during the Open Enrollment Period, including:

Changes to your plan’s network– Every year, there will be changes made to your health insurance plan, including to your network of doctors and specialists. This means doctors that you might have been going to for a long time might no longer be in your network, and if you choose to continue seeing them, you will have to pay a lot more out-of-pocket.
You are moving– If you are moving, your current health insurance plan might not work in the area you are moving to, so you will have to find a new plan and doctor.
Your family situation has changed– If you are adding a family member to your plan or if you have lost a family member, you’ll need a plan with more or less coverage.
You’re not happy with your coverage– If you’re looking to save some money, you might want to look for a plan with less coverage, or if you feel that your plan doesn’t offer enough coverage for you and your family, you’ll want to look for one with more benefits.

Things To Keep In Mind When Switching Plans

Before you make a decision to switch plans, there are a few things that you have to consider. When looking for a plan that is right for you, focus on:

All of the costs associated with each plan– You’ll need to take into consideration not just the price of each plan’s monthly premiums, but also the deductibles, co-pays, and coinsurance that you’ll be responsible for paying out-of-pocket.
The network– Do you have a particular doctor who you want to continue seeing? Make sure that you review each network’s plan, so you will know if your doctors are covered.
The coverage– Each plan will cover services differently: for example, some will not cover a medical procedure or drug, while others might cover it completely. You need to determine what you need covered, as well as review the preventive care services, prescription drug formulary, and other coverage associated with each plan.

How To Switch Plans

illustration of a woman with a headset on sitting in front of a computer — *Working with an EZ agent will allow you to find the best plan and deal in your area, for free.*

The best way to find a plan that suits your needs is by working with a licensed agent who is familiar with all the plans in your area, and who can go over any changes to your plan, like increases to your premiums, with you. EZ offers personal agents who will compare all available plans in your area and even help you switch plans for free – they will even take care of all the little details of switching and making sure everything is all set with your new plan, like notifying your current health insurance company that you are moving on.

Our agents work with the top-rated insurance companies in the country, so they have quick and easy access to all plans in your area. They will go over your medical and financial needs, and then compare all plans, including their coverage, premiums, deductibles, and other costs associated with each plan. We will help you find an affordable plan, and maybe even lower your health insurance costs! To compare plans in your area for free, enter your zip code in the bar above, or to speak to one of our highly trained, licensed agents, call 888-350-1890.

The Complete Guide to Open Enrollment for Employers

It’s here! Open Enrollment for your group health insurance plan has come around again, running from November 1 – December 15. Now is the time when you can choose new benefits, or review and change existing health insurance benefits for your employees, and we get it: this time of year can be hectic and stressful, with all of the questions that employees (and you!) might have. Not only that, but you’ve got the weight on your shoulders of knowing that this is your one chance to get this done until next year! But don’t worry, we’ve got you – first, check out our tips below for a smooth Open Enrollment, and then speak to an EZ agent who can help you find the perfect plan for you and your employees.

employees sitting at desks in an office — *To qualify for group health insurance, your business must have at least 1 full time employee other than yourself or your spouse.*

Does Your Small Business Qualify for Group Health Insurance?

Let’s start with the basics. If you’re new to offering group health insurance to your employees, you might be wondering how you qualify to offer it. Well, it’s actually pretty simple, and more likely than not, your business will qualify! You need to:

Have at least one full-time employee who is not the business owner, or the spouse of the business owner
Be legally registered as a business entity in your state (regulation for this varies from state to state)
Contribute at least 50% to your employees’ monthly premiums

Why Take Advantage of Open Enrollment?

Ok, so your business qualifies to offer group health insurance, but should you? And if you’ve already got a plan in place, why review it during Open Enrollment? Well, there are a few very good reasons to do both:

You and your employees can save money – Enrolling in a group health insurance plan is often cheaper than enrolling in an individual plan. Not only that, but the more employees you can get to sign up, the cheaper the plan could be.

Changes in life circumstances mean changes in insurance needs – If you do already offer group health, you definitely need to take advantage of Open Enrollment and use this time to reassess your and your employees’ needs. Has anything major changed, like births, deaths, or marriages? If so, you might be able to find a plan that offers better or more tailored coverage for a better price.

Group health can mean tax advantages – Who doesn’t love to save on their taxes? Take this time to look into ways you could be saving, like checking if you qualify for the small business health care tax credit, or by choosing to offer tax-advantaged healthcare options, like HSAs, FSAs, or HRAs.

What Should You Be Thinking About When Choosing a Plan?

Another important basic step in the process: knowing what you should be thinking about when exploring your options. Here are 4 essential factors that should go into your decision-making process:

Costs associated with the plan – You’ll want to consider how much employees want to pay in premiums, while also remembering that you have to contribute at least 50% of the amount each month. Also keep in mind things like deductibles, copays, and coinsurance that can all add up, depending on how often your employees access medical services.
The metal tiers of available plans – Familiarize yourself with the so-called metal tiers of plans: Platinum, Gold, Silver, and Bronze. These terms have nothing to do with quality of care, rather they indicate what percentage of costs a plan will pay for covered benefits. For example, popular Silver plans will usually cover around 70% of costs, with the insured paying the remaining 30%.

The type of plan you want – In addition to choosing a metal tier, you’ll also have to consider what type of plan you want to offer to your employees. For example, you can choose from HMO, PPO, POS, and EPO plans; each of these types of plan will offer different price points, since some are more flexible about things like network coverage.

Insurance companies – Check out which insurance companies offer plans in your area, and what their networks look like; you want to be sure that they offer affordable care in locations that are convenient for your employees.

What Should Employees Consider?

So you know what you need to be thinking about, but are you ready to answer your employees’ questions, or take on their concerns? You can help guide them in choosing or changing their plan by telling them to take the following factors into consideration:

The price of the plan – Let your employees know exactly how much the plan will cost them per paycheck.

Their dependents – Your employees should think about who they will need to have covered by their plan, especially if they plan on adding on family members in the coming year, or if they have added any new household members since last year. You’ll also need to make clear your policy on contributing to dependent coverage.

Any changes in coverage – Make sure your employees know what is covered under the plan, especially if there is anything new being added, like dental or vision coverage.

Any added benefits – In addition, if your plan is going to have any new benefits, like telemedicine or wellness programs, let your employees know.

Top Tips for Employers

Group health insurance can seem a bit overwhelming, especially since studies show that 35% of employees have little to no understanding of their healthcare coverage! Not only that, but 22% of employees are confused during open enrollment, 20% are anxious, and 21% are stressed, so it can be tough to know how to approach this subject. But there are some ways to make the process go a little more smoothly. For example, you can:

Go digital – You don’t have to print out reams of paper, or have endless meetings with employees about benefits (which might be tough with all of the work-from-home going on right now)! Save paper, toner, and your and your employees’ sanity by offering everything in PDF form, and by considering holding a virtual benefits fair, which employees will be able to access when it works for them from the comfort of their home.

Keep it simple – When emailing employees about their benefits, be as concise as possible, with price per paycheck and benefits clearly laid out, using language that is easy to understand. You can also include any FAQ sheets you get from your insurer or agent, as well as a glossary of terms and acronyms.

Send out a survey – While you do have to be careful about privacy when it comes to employees’ health, there is no reason why you can’t send out an anonymous survey to find out what your employees are most interested in when it comes to their insurance plan, so you can either make a choice to change the plan you’re offering, or can recommend the right plan to them.

Be creative with your communication – Email is great, but you have tons of options when it comes to follow-up communication and reminders about enrollment, including:

- Text messages
- Posters
- A dedicated intranet webpage
- Videos on screens in common spaces
- Notices on paychecks (both hard checks and online)
- A chat channel, through a platform like Slack
- A Twitter chat, complete with hashtags that other employees can search

Yes, it’s Open Enrollment time again, what some might consider the most confusing time of the year. But you know? You got this, and we’ve got your back if you need help choosing, reviewing, or changing your employees’ healthcare plan. Come to EZ.Insure for a dedicated agent who can answer all of your questions, every step of the way, as well as find you fast, accurate quotes and sign you up for a great plan – all for free! No hassle, no obligation. To get started with us today, simply enter your zip code in the bar above or to speak to an agent, call 888-350-1890.

Tag: ACA OEP