Affordable Care Act (ACA) Special Enrollment Period
Do You Have AMajor Life Change on the way?
Reporting Life & Income changes to the Marketplace
Once you have Obamacare, or Affordable Care Act (ACA), Marketplace coverage, you must report certain life and income event changes. This information may affect the coverage or savings you're eligible for. Copeland Insurance Group can help you report the changes and update the necessary information to the Obamacare (ACA) Marketplace.
When & How ToReport Changes
You should report these changes as soon after the change as possible. If the changes qualify you for more or less savings, it's important to make adjustments as soon as possible.
After we help you report changes to the Obamacare (ACA) Marketplace, you'll get new eligibility results that explain: Whether you qualify for a Special Enrollment Period that allows you to change plans or whether you're eligible for different savings. At that point, we can help you shop for a different plan and you usually have up to 60 days from the date of the qualifying event to enroll in a new plan.
Nine Qualifying Reasons for a Special Enrollment Period
Involuntary loss of other coverage that is qualified as minimum essential coverage.
(Cancelling the plan or failing to pay the premiums does not count as involuntary loss)
- Individual plan renewing outside of the regular open enrollment.
- Becoming a dependent or gaining a dependent as a result or birth, adoption, or placement in foster care. Coverage is backdated to the date of birth, adoption, or placement in foster care.
Becoming a United States citizen.
(This qualifying event only applies within the exchanges – carriers selling coverage off-exchange are not required to offer a special enrollment period for people who gain citizenship or lawful presence in the US)
- A permanent move to an area where different qualified health plans (QHPs) are available. A permanent move to a new state will always trigger a special open enrollment period, because each state has its own health plans.
- An error or problem with enrollment (or non-enrollment) that was the fault of the exchange, HHS, or an enrollment assister.
Employer-sponsored coverage reducing benefits such that it no longer provides minimum value, or becomes unaffordable.
(Defined as requiring the employee to pay more than 9.69 percent of income for just the employee’s portion of the coverage in 2017)