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.

Preparing for 2016 Open Enrollment

Open Enrollment is a set time period each year during which anyone can buy a new health insurance plan for any reason.

If you enroll during Open Enrollment, you cannot be denied coverage.

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

If you are currently uninsured, this is your chance to get coverage for 2016 and avoid a penalty tax for being uninsured.

If you are currently covered under an individual/family health plan (vs. having coverage through your employer), you can expect to hear from your health insurance carrier sometime in October with news about any changes the company will make 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 want to switch plans in 2016, first find out if you will qualify for a subsidy based on your projected 2016 income:

# People in Your Household
	1	2	3	4	5	6
You may qualify for a premium subsidy if your yearly 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

Browse 2016 Health Plans

If you do qualify and you live in Virginia, visit www.enrollvirginianow.com to take a preliminary look at 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, you’ll want to purchase coverage directly from the carrier of your choice. We offer convenient one-stop access to preview and enroll in “off-exchange” plans in Virginia and Maryland, as well as all plans in DC, at www.vamedicalplans.com. Click on Get Quotes. We’ll send you updated pricing as it becomes available.

Open Enrollment Starts November 1

The first day you can enroll in a 2016 plan is November 1, 2015. But we expect the carriers to update our websites with 2016 plans and pricing in mid-October.

We are available to help you sort through your options so you’re ready to go when Nov 1 comes around.

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.

*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.

Maryland CareFirst Premiums Set to Rise in 2016

If you live in Maryland and are covered by a CareFirst health insurance plan, chances are you’re going to see an increase in your monthly premiums in 2016.

Effective January 1, CareFirst premiums in Maryland will be on average 26% higher than rates in 2015.

What Can You Do?

At Virginia Medical Plans, our number one goal is to educate you about your options and help you choose the one that best meets your needs — and your budget.

Because we work with all the major carriers, we may be able to secure a plan for you with another insurer at a more competitive price.

We may find, however, that because CareFirst continues to have the largest HMO and PPO networks for plans in Maryland, switching carriers is not an attractive option. In that case we can examine other plans with CareFirst. For example, an HSA-compatible plan may help mitigate any premium increase and provide tax breaks to families with higher incomes.

Open Enrollment Begins November 1

Open Enrollment begins November 1 and extends through January 31. During this time, you may select new 2016 coverage for any reason.

If you enroll in coverage …	Your coverage will begin …
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 faced with a price increase for 2016, we recommend researching your options.

You can view plans and pricing by clicking the Instant Quote button above and requesting a free quote. We expect 2016 data to be available in mid- to late-October.

Virginia Medical Plans Can Help

We are standing by to answer any questions you may have. Give us a call at 703-707-8270.

There is never a charge for our services, and we are happy to be of assistance!

 

 

 

Buying Health Insurance in Virginia, Maryland, or DC

The Affordable Care Act (ACA) has made it mandatory for most Americans to have health insurance.

In addition to making health insurance mandatory, the new law also makes health insurance guaranteed issue.  This means you cannot be denied coverage for any reason — even if you have a pre-existing medical condition.

If you live in Virginia, Maryland, or the District of Columbia, Virginia Medical Plans can help you get the coverage you need — and avoid a penalty for being uninsured.

Open Enrollment for Health Insurance

During certain times of the year, anyone can buy coverage, for any reason. This time is known as open enrollment:

• For plans effective in 2015: Nov 15, 2014 through Feb 15, 2015 (now closed)
• For plans effective in 2016: Nov 1, 2015 through Jan 31, 2016

Buying Coverage Outside of Open Enrollment

What if you need coverage outside the dates of open enrollment?

Certain life events are considered qualifying events and trigger a special enrollment period during which you may buy a plan.

What are Qualifying Events?

Examples of qualifying events:

• Change in marital status (marriage/divorce/death of a spouse)

• Relocation to a new state or to an area of your current state where the plans offered are different

• Change in family size (birth/adoption/death of a child)

• Involuntary loss of minimum essential health coverage (change in employment status, cancellation of current coverage)

• Certain changes in income

• Expiration of COBRA benefits

• A change in family structure — for example becoming a dependent or gaining a dependent through birth, adoption, or placement in foster care — which causes your current plan to no longer meet your needs.

• An increase in your income to the federal poverty level (FPL) if you live in a state which has not expanded Medicaid. Earning at least 100% of FPL takes you out of the Medicaid coverage gap and makes you eligible for premium tax credits when buying health insurance on the exchange.

• A court order requiring you to provide health insurance (for example during divorce proceedings).

• Termination of your pre-Affordable Care Act plan outside open enrollment.

What Should You Do if You Have a Qualifying Event?

If you have a qualifying event, you must submit proof of the event and the date it occurred in order to purchase a new plan. Without proof, most carriers will not process your application.

You have a limited amount of time after a qualifying event to purchase new coverage, so you must act quickly.

Contact us right away so we can direct you to your best option.

If you have a qualifying event and are eligible for a subsidy (click here to find out), then you need to purchase coverage on your state’s health insurance exchange (healthcare.gov for Virginia residents, marylandhealthconnection.com for Maryland residents, dchealthlink.com for DC residents).

If you are not eligible for a subsidy, you can apply directly with the carrier of your choice:

• CareFirst BC/BS
• Anthem BC/BS
• Kaiser Permanente
• Humana
• UnitedHealth Care
• Innovation Health/Aetna

Whether you buy coverage directly from the carrier or on your state’s exchange, a quick call to our office at 703-702-8270 will allow us to help you understand your options and choose the plan that makes the most sense for your health needs and your budget.

Short-Term Health Insurance

Without a qualifying event, you can purchase a short-term health plan outside of open enrollment. These plans provide limited coverage, so please be sure you understand what you’re buying.

Contact Virginia Medical Plans

Call us today at 703-707-8270 and we will walk you through your options.