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Millions May Qualify for Special Enrollment

Millions May Qualify for Special Enrollment

As you know, the Affordable Care Act gives people the opportunity to purchase or change health coverage during the ACA’s individual open enrollment period. And, as you also know, the 2018 open enrollment period was only half as long as last year’s. For 2017 plans, people had three months to sign up; for 2018, they only had six weeks. The open enrollment period officially closed December 15, 2017.

BUT—and this is a big one—millions of people may still be eligible to select an individual health plan for 2018. That’s because the Affordable Care Act gives people who have certain qualifying events an opportunity to purchase health insurance during a 60-day Special Enrollment Period (SEP). And one of the qualifications for a SEP, as Healthcare.gov explains, is the loss of other coverage.

Because a number of carrier decisions for 2018 forced many Americans to select new health plans, those individuals are eligible for a SEP that lasts through the end of February.

If we look at the Texas market, for example, at least three health insurers—Aetna, Cigna, and Humana—all made the decision to stop offering individual health plans for 2018. Existing coverage terminated on December 31, and that created a special enrollment opportunity for existing individual clients of those three carriers. Additionally, Blue Cross Blue Shield of Texas, the state’s largest individual health carrier, eliminated nearly all of its existing plans, mapping members to similar plans but allowing them to select other options if they wanted. The fact that the existing plans were eliminated gives impacted customers another 60 days to choose a different plan with Blue Cross Blue Shield or move to another carrier. Some Baylor Scott & White Health Plan members have a similar opportunity as the plan eliminated its PPO plans for 2018.

Long story short, there is still a big opportunity to sell individual clients for the next two months, and AHCP would like to help you take advantage of this opportunity. Call us to find out how we can help.

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