Public Exchanges - Am I Eligible?

The Affordable Care Act is impacting how employers are offering coverage to their employees, if they’re continuing to offer at all. An option for employees who wish to opt out of their employer sponsored plan has been, and at least for now, continues to be the accessibility of the Public Exchanges. The common question from those who may wish to opt out, since the enrollment period is over for 2014, is “When can I enroll in the Public Exchange, and am I even eligible?”

Most residents in the state of Connecticut must wait until the next open enrollment period (November 15, 2014 – February 15, 2015) to get health care coverage through our state run program, Access Health CT. However, individuals may be able to get coverage earlier, depending on their situation.

First and foremost, you can enroll at any time if you qualify for Medicaid or the Children’s Health Insurance Program (CHIP). When accessing AccessHealthCT.com, you can enter your household’s modified adjusted gross income to see if you’re eligible for these programs. If you qualify, you can enroll immediately.

The second situation is if you have a qualifying life event. A qualifying event is a change in one’s life that can make you eligible for a Special Enrollment Period to enroll. Certain life changes include changes in family size and income. Examples of other qualifying life events include:

• Getting married
• Having or adopting a child
• Change in address – moving to Connecticut from another state
• Loss of coverage (e.g., job loss, divorce, employer cancelling group coverage, expiration of COBRA)

Potential enrollees in the state exchange for a qualifying event will generally have 60 days from the date of the event. During these 60 days, individuals can enroll on a health plan or change the existing plan. However, 60 days pass and you do not sign up for health coverage, you will have to wait until the next open enrollment period, which will be in the fall of 2014.

For additional guidance please visit www.healthcare.gov. Also, contact your OneDigital Consultant if you would like to discuss further in detail.