2016 Open Enrollment – What You Need to Know

Open Enrollment has begun!

Open Enrollment is a set time period each year during which anyone can buy a new health insurance plan for any reason. You cannot be denied coverage during Open Enrollment.

Open Enrollment for 2016 health coverage is November 1, 2015 – January 31, 2016.

If you apply between …	Your coverage will be effective …
November 1, 2015 – December 15, 2015	January 1, 2016
December 16, 2015 – January 15, 2016	February 1, 2016
January 16, 2016 – January 31, 2016	March 1, 2016

If you are uninsured, Open Enrollment is your chance to get coverage for 2016 and avoid a penalty tax.

If you were covered in 2015 under an individual/family health plan (vs. having coverage through your employer), your carrier should have notified you in October with news about any changes to your plan and/or pricing for 2016.

If you are comfortable with your carrier’s offering for 2016, you won’t need to do anything.

Simply continue to pay your premiums on time* and your coverage will renew (or the new plan that’s been selected for you will start) effective January 1, 2016.

However, if you’re not satisfied with what’s being offered, or if you’re curious about what else may be available, we’ve made it easy to research your options.

Will You Qualify for a Subsidy in 2016?

Whether you need new coverage or are thinking of switching plans, first find out if you qualify for a subsidy in 2016 based on your projected income:

# People in Your Household
	1	2	3	4	5	6
You may qualify for a premium subsidy if your projected 2016 household income is between ….	$11,770 -$47,080	$15,930 – $63,720	$20,090 -$80,360	$24,250 – $97,000	$28,410 – $113,640	$32,570 – $130,280

Shop for 2016 Health Plans

If you do qualify and you live in Virginia, visit www.enrollvirginianow.com to view available “on-exchange” plans. This is Virginia Medical Plans’ exclusive portal into the federal exchange that expedites enrollment — just for our Virginia clients.

If you don’t qualify, it’s best to purchase coverage directly from the carrier of your choice. We offer convenient one-stop access to view and enroll in “off-exchange” plans in Virginia and Maryland, as well as all plans in DC.  Click here.

Things to Keep in Mind

• It’s important to read all correspondence from your insurance carrier carefully.
• If you anticipate a change in income for 2016, it’s a good idea to revisit your health plan.
• If you switch plans, your network of doctors may change.
• Be mindful of the deadlines for buying 2016 coverage, shown above.
• If you switch plans after January 1, your deductibles will reset.
• If you are uninsured for more than 2 months during 2016, you will be assessed a tax penalty.

Virginia Medical Plans – One Stop Shopping for VA, MD, DC Residents

We work with all the major carriers in Virginia — both on- and off-exchange — and can advise you of the best plan for your needs. We also work with off-exchange plans in Maryland, as well as exchange plans in DC (Carefirst and Kaiser Permanente).

Best of all, there is never a fee for our services! Your premium will be the same no matter how or where you buy your coverage.

But when you work with Virginia Medical Plans, you have access to our assistance now and for the life of your policy!

We are standing by to take your call at 703-707-8270 or toll free at 888-396-2341.

*Some carriers require you to notify them if you plan to continue paying premiums via bank draft when selecting a new plan for 2016. Please check with your carrier.

Buying Health Insurance in Washington, DC

If you live in Washington DC, let Virginia Medical Plans help you choose and enroll in an individual or family health insurance plan!

If you’re eligible for a subsidy to help pay for coverage, we can also help you collect your subsidy.

Enrollment in DC plans is done through DC’s health insurance marketplace: https://www.dchealthlink.com.

You can browse available plans without creating an account, but we recommend you create an account so you’re ready to enroll once you’ve selected your coverage.

Get started by following these steps:

1. Click on “APPLY” and create an account.
2. Once your account is created please click on “select the trained expert assisting you” in the upper right hand corner.
3. Enter our reference number so that we may assist you – 5376842.
4. Click search, then next.
5. Fill out the basic demographic information (name / address / contact information) and then browse available plans.
6. Call us to assist with plan selection and final enrollment into the selected plan.

The first day to enroll in 2016 health coverage is November 1, 2015, with open enrollment running through January 31, 2016.

We are happy to assist you and there is never a charge for our services!

Call our office at 703-707-8270.

 

 

 

COBRA vs. Individual/Family Health Insurance Plan?

If you lose your job-sponsored coverage, should you go on COBRA or buy a health plan on your own?

Before the Affordable Care Act (ACA, aka Obamacare), leaving a job meant either getting private health insurance (which was sometimes difficult because of pre-existing conditions), going without health insurance (NOT a good option!), or paying for coverage under COBRA.

COBRA — the Consolidated Omnibus Reconciliation Act — is the federal law that gives you the right to continue your employer-sponsored health insurance coverage for 18 months.

The problem with COBRA, however, has always been the expense.

Under COBRA, you pay both the employee AND the employer portion of your employer-sponsored health insurance premium, plus an administrative fee.

If you are accustomed to getting health insurance through your employer, you may not realize that the typical employer pays approximately 73% of its employees’ health insurance premium and about 71% of family coverage.

Affordable Care Act (ACA)

COBRA is no longer your only option if you lose your job-sponsored coverage. Under the Affordable Care Act:

• You cannot be denied coverage for pre-existing conditions.
• Depending on your income, you may be eligible for a premium subsidy, making coverage more affordable.
• Losing your employer-based coverage is a qualifying event which triggers a special enrollment period. You have 60 days from the date your employer-based coverage ends to enroll in a new plan. (Note, under COBRA, you have 63 days to enroll, and must pay premiums retroactively if you enroll anytime after the first day you’re eligible.)

Which is Better: COBRA or Individual Health Insurance?

As with most questions, the answer depends on your specific circumstances. Consider the following:

COST: When comparing the cost of COBRA and individual/family health plans, remember to consider not only the premiums, but also the out-of-pocket expenses (co-pays, deductibles, etc.) associated with each plan. Also consider the subsidies available for individual/family plans when you purchase coverage on your state’s health insurance exchange. Subsidies are determined based on your household income. Click here to see if you may be eligible.

TIMING:  If it’s January — meaning you have earned only one month’s salary for the year — an exchange plan with a subsidy could be a good option. However, if it’s October — meaning you’ve accrued almost a year’s worth of income — you may not be eligible for a subsidy, or may be entitled to a lower subsidy amount. Also, if you are far into your employer plan’s year and have already met your deductible, it may be best to stick with your current plan and go on COBRA. Keep in mind, expiration of COBRA is also a qualifying event. This means you can enroll in an individual/family plan when your COBRA coverage ends. In addition, there is a yearly Open Enrollment period during which you can enroll in individual/family health coverage — with or without a qualifying event.

YOUR CURRENT HEALTH STATUS: If you are currently undergoing treatment for a medical condition (for example, cancer or pregnancy), you may be better off choosing COBRA in order to stay with your current doctor and insurer through the course of your treatment. If you have already met your plan’s deductible, it may also be better to go on COBRA. Note, a pre-existing condition won’t prevent you from enrolling in new coverage, but you still may prefer to stick with your current plan.

YOUR AGE: Because individual/family plans can charge higher premiums for older individuals but employer-based plans usually don’t, older people may fare better with COBRA, whereas younger people will likely find lower premiums in the individual market.

Virginia Medical Plans Can Help

We are available to help you explore your options on the individual health insurance market — both on and off the Exchange.

If you have lost (or will be losing) your employer-based health insurance, we recommend researching your options for new coverage. But don’t delay because remember, you have 60 days from the date your current coverage ends to enroll in a new plan, or 63 days to elect COBRA.

• If you live in Virginia and are eligible for a subsidy, visit www.enrollvirginianow.com to see plans and pricing.
• If you are not eligible for a subsidy, click here to get an instant quote.

Reach us by phone at 703-707-8270 to go over your options with our licensed insurance broker. There is never a fee for our services!

What is the Penalty for Not Having Health Insurance in 2016?

If you went for more than 3 months without health insurance in 2015, you will be assessed a penalty when you file your 2015 income taxes.

Here are the penalty amounts for not having coverage in 2015 and 2016.  Note that not having coverage in 2016 will cost you more than double the 2015 charge:

2015	2016
$325 per adult $162.50 per child Family Maximum of $975 OR 2% household income, whichever is GREATER	$695 per adult $347.50 per child Family Maximum of $2,085 OR 2.5% of household income, whichever is GREATER

The penalty fee will be adjusted for inflation in future years.

Avoid a Penalty in 2016 – Get Covered During Open Enrollment!

Open Enrollment for 2016 health insurance runs from November 1, 2015 through January 31, 2016. You can save yourself a substantial penalty by making sure you have coverage in place for you and your family.

Virginia Medical Plans works with clients in Virginia, Maryland, and the District of Columbia, and can help you find the best coverage for your needs:

• If you live in Virginia and are eligible for a subsidy, visit www.enrollvirginianow.com to view plans and options.
• If you are not eligible for a subsidy, you can view available plans and options by clicking here.

If you see a plan you like, you may enroll online.

We encourage you to take a look at your options and then call our office to review them with our licensed broker.  We can help you choose the plan that will best meet your needs.

Call our office at 703-707-8270. We are standing by to take your call.

The last day to secure coverage effective January 1, 2016 is December 15, 2015.
We expect heavy call volume during Open Enrollment, so please don’t delay!