Chelsey Tucker graduated with a Bachelor of History degree from Metropolitan State University in 2019. She now writes about insurance with her specialty being life insurance and has been quoted on Help Smart Phone and MEL Magazine.

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Dan Walker graduated with a BS in Administrative Management in 2005 and has been working in his family’s insurance agency, FCI Agency, for 15 years. He is licensed as an agent to write property and casualty insurance, including home, auto, umbrella, and dwelling fire insurance. He’s also been featured on sites like Reviews.com.

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Reviewed by Daniel Walker
Licensed Auto Insurance Agent

UPDATED: Mar 19, 2020

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The lowdown...

  • Open enrollment for 2017 ends on January 31, 2017
  • Open enrollment for 2016 ended on January 31, 2016
  • The special enrollment periods end within sixty days
  • Extensions begin and end as the governments announce


Open enrollment ended with the last day of January 2016. The date can vary if using a special enrollment, an extension, or employer plan. Comparison shopping is a tool that helps consumers find the best insurance policies for their needs. This method can focus on the features that matter most to the individual or family situation. Enter your zip code in our FREE tool above to compare health insurance rates now!

The Individual Mandate

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The Affordable Care Act requires citizens and legal residents to get health insurance coverage or pay a tax penalty. Unless exempt, those that fail or refuse to get qualified health insurance coverage must pay for each month of no insurance. The exemptions include hardship and those with no taxable income do not need to be covered.

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The Penalty for No Insurance

The IRS administers the penalty for no insurance. The individual shared responsibility payment is one-twelfth of the total amount due for each month of no insurance. The IRS will apply the greater of 2.5 percent of family income or the total of the below-described items.

  • The 2016 penalty per each adult individual $695.00, added to
  • The 2016 penalty per each child or minor $347.50; up to
  • The 2016 family maximum amount of $2,085.

The Open Enrollment Period

The open enrollment period is an important part of the health insurance calendar. It is the time when every eligible person has a right to buy affordable, qualified health insurance. The federal government and the states that run exchanges each announce the open period term. For the federal marketplace, the 2017 open enrollment period runs from November 1, 2016, through January 31, 2017.

Special Enrollment Periods

The federal rules and state governments recognize that status changes occur during and after the open enrollment period that requires a new opportunity to buy health insurance.

The special enrollment periods run for a sixty-day term measured from the date of the qualifying event or the date the government grants the extension.

In states that recognize childbirth as a qualifying event, the coverage relates back to the birth date and covers the newborn from birth.

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The New York Pregnancy Exception

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The state of New York passed a law in 2016 to make pregnancy a qualifying event for a special enrollment period under the Affordable Care Act. The federal rule is different; childbirth is a qualifying event but pregnancy is not.

The advantage in both state and federal rules is that the childbirth event the date of coverage is the date of birth. Depending on individual situations, using the birth date can save some weeks of waiting.

Extensions

States and the federal government have power to extend the open enrollment period. In the past, they have used extensions to help applicants with incomplete applications. They have also used extensions when system overcrowding and long online waits have interfered with sign-ups.

Extensions are usually short extensions designed to accommodate applicants and resolve a short-term issue. States have used extensions to overcome problems caused by natural events, floods, storms, and interruptions to power grids.

The Nevada Exception

The state of Nevada requires off-exchange providers to offer health insurance enrollment on a year-round basis. Insurers may not discriminate against any applicant for pre-existing conditions. They offer non-subsidy policies. The rules permit insurers to delay coverage by up to 90 days.

In Nevada, consumers can get coverage year-round with quality health plans purchased off-exchange.

They cannot get tax advances and financial assistance unless they purchase through the exchange during open enrollment, an extension, or a special enrollment period.

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Employer-sponsored Plans

The last day to sign-up for an employer plan can be different than the federal or state government dates. Employers can set a time for sign-up that applies to the group. Further, new employees must get an offer of insurance coverage within 90 days of their hiring date. The last day of enrollment varies in employer-sponsored plans and also goes to the point of hiring.

Life Events

The state and federal rules include the below-listed items as life events.

  • Divorce
  • Marriage
  • Childbirth
  • Adopting a child
  • Losing dependent status on Parent’s policy at age 26
  • Losing employer-sponsored coverage as a dependent

Medicaid

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Citizens and legal residents that do not qualify for Obamacare policies can get Medicaid if their incomes fall below the limit for the program. There is no last day for Medicaid enrollment, qualified applicants can get coverage at any time. The year-round registration period depends on meeting the upper limit of the income range. Those that earn more than the limit may not get coverage.

Medicaid meets the requirements of the Affordable Care Act for essential health benefits. Medicaid satisfies the individual mandate and residents with Medicaid coverage will not face the individual shared responsibility payment.

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The CHIP

The Children’s Health Insurance program protects infants and minors that need medical coverage. The program accepts children without regard to their ability to pay. The low or no costs services include dental care and vision care in most states. The CHIP enrollment is year-round and always open. Eligible families can enroll at any time.

Medicaid Expansion

The solution to the Medicaid gap was federal funds to raise the limit for Medicaid coverage to 138 percent of the poverty line. Federal funding for several years of program operation made the transition easier for state budgets. The goal was to insure a large additional number of Americans.

In states that adopted the expansion, it is easier to qualify for Medicaid coverage.

Estimates of the scope of the expansion projected about 20 million additional insured persons over a ten-year period.

The Medicaid Gap

Between the lower limit for Obamacare and the upper limit for Medicaid, a range of incomes fails to qualify for coverage. This is the Medicaid Gap; the incomes that are too low for Obamacare and too high to get Medicaid. The Congress recognized this problem when enacting the Affordable Care Act and authorized Medicaid expansion.

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Apply Early to Avoid Problems

Applying before the last day is enough to avoid the penalty and get coverage. The better advice is to apply as early as possible in the open enrollment period. Early applicants can have time to review their choices and make changes including switching to a new policy.

Start comparing health insurance rates now by entering your zip code in our FREE tool below!

Comparison shopping is a dynamic process for finding the best fit among health insurance policies and options. Consumers can use it to focus on the features that matter most to their situations. They can go far beyond comparing premiums and look at the true costs of insurance.