The fourth annual open enrollment period began November 1 for 2017 health coverage. The Department of Health and Human Services (HHS) expects 13.8 million people to select a health plan during open enrollment, about one million more than last time. The health insurance marketplaces will offer individual and family plans through January 31, however, if coverage is needed starting January 1, consumers must sign-up by December 15.
The Affordable Care Act (ACA) created the online exchange system to make it easy and convenient for individuals to shop for health insurance coverage. Some states have set-up their own marketplaces for their residents to purchase plans from, yet many (39 states for 2017) still rely on the federal healthcare.gov program to handle enrollment.
According to a National Underwriter Life & Health November 2016 article, consumers can also shop for ACA plans through 57 web broker entities. These are approved healthcare.gov plan distributors that connect into the healthcare.gov sales information to use on their own web-based insurance sites.
Individuals and families with no employer-sponsored coverage can also find help from qualified agents and brokers in their area. For 2017 healthcare.gov has certified over 39,000 exchange plan producers, who have received training specific for the 2017 plan offerings and options.
On of the most important steps a broker or agent can help with is determining if a consumer qualifies for a subsidy. According to the Centers for Medicare & Medicaid Services (CMS), in January 84% of enrollees were receiving an advance premium tax credit and 56% were receiving cost-sharing reductions. These types of subsidies are available to individuals earning $47,520 or less or for a family of four making up to $97,200 and who shop on the exchanges.
Exchange producers will also be knowledgeable about plan choices and even more specifically deductibles and out-of-pocket limits within each tier of plans. Prescription drugs are another concern most enrollees need help understanding. Many plans on the exchanges require the plan deductible to be met prior to covering prescription costs. It becomes critical for saving money that consumers find a plan that covers their prescription drug needs.
The government reported last month that approximately 2.5 million people are missing out on subsidies by not purchasing plans on an exchange. This month and next offer individuals and families the ability to get a qualified plan that suits their needs and budget and an opportunity for certified exchange brokers to use their expertise in the process.
Source: Money. The Best Cure For Obamacare Woes. November 2016. P 36.
