Smart Benefits: Important Reminders for 2016 Exchange Open Enrollment

Monday, November 02, 2015

Rob Calise, GoLocalWorcester Business/Health Expert

With the state and federal marketplace open enrollment periods now underway, there are key things consumer need to keep in mind.

•   Open Enrollment Period: Open enrollment started November 1 and runs through January 31, 2016. For those who sign up before December 15, coverage will start January 1; those who enroll between December 16 and January 15, 2016, will have effective dates of February 1, 2016; and those who sign up between January 16, 2016, and January 31, 2016, will have a coverage start date of March 1, 2016. Anyone who misses open enrollment may sign up for coverage if they qualify for a special enrollment period due to events like marriage, the birth of a child or loss of coverage.
•   Automatic Renewal: Coverage for those consumers who are enrolled in a 2015 exchange plan will be automatically renewed, as long as they remain qualified and the plan they originally had is still available (they’ll be enrolled in a similar plan if it’s not). If the plan is making any changes to its provider network, copays, co-insurance and drug coverage for 2016, it must send consumers a notice. Those who want to change plans for 2016 must act by December 15.
•   Tax Credits: If consumers are eligible for a premium tax credit, they need to update their expected income and household information for 2016 to ensure the credit is accurate.
•   Penalty: The penalty for those who opt to go without health insurance in 2016 rise to 2.5 percent of their income or $695 per adult (whichever is more); the penalty for each child in the family under 18 without coverage increases to $347.50. Individuals can be exempt from paying the fee if they qualify for a hardship or religious exemption.

Rob Calise is the Managing Director, Employee Benefits. of Cornerstone|Gencorp , where he helps clients control the costs of employee benefits by focusing on consumer driven strategies and on how to best utilize the tax savings tools the government provides. Rob serves as Chairman of the Board of United Benefit Advisors, and is a board member of the Blue Cross & Blue Shield of RI Broker Advisory Board, United HealthCare of New England Broker Advisory Board and Rhode Island Business Healthcare Advisors Council. He is also a member of the National Association of Health Underwriters (NAHU), American Health Insurance Association (AHIA) and the Employers Council on Flexible Compensation (ECFC), as well as various human resource associations. Rob is a graduate of Bryant University with a BS in Finance.

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