2015 Health Insurance Plan Notifications FAQ

2015 Health Insurance Plan Notifications FAQ

Not certain if your health insurance plan is set to automatically renew? Unclear about when your 2014 coverage ends? Renewal notifications will go out leading up to 2015 open enrollment, which begins Nov. 15, so pay attention to correspondence from your health insurance company in the days to come.

 We’ve outlined the basics below, so you have an idea of when to expect information regarding your current health insurance plan and future coverage.

When does 2014 health insurance coverage end?

Regardless of your 2014 health insurance plan’s effective date, it will expire or renew on Jan. 1, 2015. That means, even if you purchased coverage late in the 2014 enrollment period and the plan took effect May 1, 2014, or qualify for a special enrollment period and begin coverage effective Dec. 1, 2014, you will need to renew it or select a new plan that takes effect Jan. 1, 2015.

Renewal notices

Health insurance companies must provide written notices of renewal for non-grandfathered coverage in the individual market before the first day of the next annual open-enrollment period—Nov. 15, 2014.

Written notices for grandfathered plans in the individual market and all plans in the small group market must be provided to plan sponsors or individuals at least 60 days before the renewal of coverage—Jan. 1, 2015.

These notification deadlines apply to health insurance plans purchased on and away from the state-based and federally facilitated exchanges. However, according to the NAIC, some states require renewal notices to go out 90 days from renewal and there is still some question as to how this may impact the process in those states.[1] The NAIC recommends consumers contact their state insurance department with concerns.

The CMS requires federal standard renewal notices to include:

  • What plan you will be enrolled in for the upcoming policy year
  • Monthly premium and advance premium tax credit information
  • Details regarding significant changes to coverage
  • Information about additional health coverage options
  • Who to contact with questions

States that operate their own exchanges may develop their own notices, as long as they are “at least as protective” as the standard federal notices.

Automatic re-enrollment

All federally facilitated exchange plans will automatically renew on Jan. 1, 2015, and some state-based exchanges have decided to do the same. At this point, you will be automatically re-enrolled in the same health insurance plan (or one that is similar, if it has been discontinued) and will receive the same subsidy, unless you notify your exchange of family and income changes.

However, you can still select different coverage—on or away from the exchange. If your plan automatically renews on Jan. 1 and you decide you want different coverage, you have until Feb. 15 to shop and enroll.

As with all health plans, written notices must be sent prior to the first day of open enrollment. Again, state laws may vary and require more time. Health insurance plans that are not set to automatically renew or cannot be automatically renewed will expire at the end of the year, and those enrolled in them must enroll in another plan by Dec. 15, 2014, to ensure they have coverage effective Jan. 1, 2014.

Discontinued plans

If your health insurance plan is discontinued and you are set up for auto-renewal, you will be switched to a similar plan. Otherwise, your coverage will simply end with 2014.

By law, health insurance companies must notify consumers that their health insurance coverage will be discontinued and that they have other options. Written notices must be sent at least 90 calendar days before discontinuation—this would have been Oct. 3, 2014. However, because many companies will not finalize 2015 plan offerings until close to the start of 2015 open enrollment, these notices may arrive late. CMS has decided it will not enforce the 90-day notice rule this year “as long as the issuer sends the notice consistent with the timeframe applicable to renewal notices” and has encouraged states to “provide similar flexibility to issuers.”

Federal standard discontinuation notices will:

  • State that your coverage is being discontinued
  • Let you will be automatically enrolled in another plan
  • Provide information about related changes
  • Offer information about additional coverage options
  • Include contact information should you have questions.

Again, states operating their own exchanges may develop their own notifications.

Open enrollment reminders

In addition to keeping an eye out for mail from your health insurance company, also look for email from them and your state’s exchange. These messages may contain important information regarding 2015 open enrollment.

Regardless of whether or not your plan will automatically renew, be sure to consider your healthcare needs and financial situation in the year to come. Plan options and rates on the exchanges and in the private marketplace will change from one year to the next. Spend some time comparison shopping on your state’s exchange and in the private marketplace (look details such as premium rates, deductible, networks, copayments and coinsurance), recalculate your premium tax credit eligibility, and reach out to a licensed agent or broker with questions about plan selection and enrollment.

Open enrollment begins Nov. 15, 2014, and runs through Feb. 15, 2015. If you want to avoid a gap in health insurance coverage, be sure to enroll by Dec. 15, 2014, for a Jan. 1, 2015, effective date. Those who enroll between Dec. 16, 2014, and Jan. 15, 2015, will begin coverage Feb. 1, and those who enroll between Jan. 16 and Feb 15 will begin coverage March 1. After Feb. 15, you must qualify for a special enrollment period to shop for a qualified health insurance plan.

You can start preparing for open enrollment now. Visit HealthCare.com to calculate your premium tax credit subsidy for 2015.

 

 

 

 

References

Department of Health & Human Services. “Form and Manner of Notices When Discontinuing or Renewing a Product in the Group or Individual Market.” Sept. 2, 2014. http://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/Renewal-Notices-9-3-14-FINAL.PDF.

 

[1] NAIC. Email Correspondence. Oct. 22, 2014.

About Jenifer Dorsey

Jenifer Dorsey is a regular contributor to HealthCare.com. She has covered health insurance and health and fitness for more than five years. In her free time she is a competitive track cyclist and loves to travel, especially to places with velodromes.

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