Getting Ready Open Enrollment 2016

Automatic re-enrollment: Keeps you covered, but without updated savings

If you don’t update your application or change plans by December 15, 2015, you’ll probably be automatically re-enrolled in a plan for 2016. This way, you’ll stay covered starting January 1.

It’s a fallback, but it’s not your best choice.

If we automatically re-enroll you and you don’t update your application with income and household changes you expect for 2016, your premium tax credit may not be accurate. This means you may:

  • Pay a higher premium each month than you need to
  • Have to pay back any advance payment of the premium tax credit you take but don’t qualify for based on your actual 2016 income at the end of the year. You’ll make this payment when you file your federal income taxes.
  • Wind up with coverage you’re not qualified for, like if someone in your household would gain or lose eligibility for Medicaid or CHIP based on an income change you don’t report

Your letters will say if you’ll be automatically re-enrolled

The letter you get from your health insurance company will say if you’ll be automatically enrolled. They’ll also tell you your 2016 premium, applying a premium tax credit that's based on your most current information.

  • In many cases, your 2015 plan will be available in 2016 and you’ll be automatically re-enrolled in it.
  • If that same plan isn’t available, you’ll probably be automatically enrolled in a similar plan.
  • In some cases, you won’t be automatically re-enrolled. See what to do if you won’t be automatically re-enrolled.

To compare plans and update, take action by December 15

  • To update your Marketplace application with income and household changes you expect for 2016 and to compare plans, act by December 15, 2015. Your new plan and savings start January 1, 2016.
  • You can still change plans until January 31, 2016. But if you wait you’ll have one plan and premium tax credit amount starting January 1 and another plan and premium tax credit starting February 1 or March 1. This can disrupt your coverage, care, and household budget.

Common questions

Your premium tax credit is based on the most current income and household size information available. That may be the information on your 2015 application, or more recent information from other sources.

It's very important to update your application with the income and household changes you expect for 2016. It's the only way to be sure you’ll get the right tax credit for the year.

  • You may need to send us information or take other actions before you qualify for a 2016 premium tax credit. Your notice will tell you what you need to do by when.
  • Updated income information from the IRS may show you don't qualify for a premium tax credit in 2016.
  • We may not have a record that you filed a federal income tax return to report and reconcile a premium tax credit you used in 2014. If you don't file a tax return for years you use a premium tax credit, we can't continue to offer you one.
  • When you filled out your 2015 Marketplace application, you didn't allow the Marketplace to use your updated tax information automatically for future years.

Important: You may still qualify for savings for 2016, even if you're re-enrolled without a premium tax credit. That's why it's critical to update your Marketplace application with your expected income and household information for 2016.

Insurance companies sometimes decide to change which health plans they offer in the Marketplace. This is a normal part of their business operations. Your health insurance company may have decided not to offer your particular plan through the Marketplace in 2016.

If so, we'll enroll you in a 2016 plan with similar pricing and coverage to your 2015 plan.

Note: An insurance company can't move you to a different plan based on your health or how much care you use. It can move you only if it's no longer offering the plan you had to anyone in your area.

You can accept the automatic enrollment in the similar plan or compare your options and change plans.

You can enroll in a different plan any time before January 31, 2016.

  • Enroll in the plan you want by December 15, 2015, so your new coverage starts by January 1, 2016.
  • Even if you're automatically enrolled in a plan you don't want on January 1, 2016, you can still change plans until January 31, 2016.
  • After January 31, you can't change plans for the rest of 2016 unless you qualify for a Special Enrollment Period.

If your plan's prices and benefits no longer meet your needs, you can compare your options and change plans for 2016.

Insurance companies can't raise your premium or change your coverage based on your health or how much care you use. Learn more about how insurance companies set premiums.

If you haven't updated your application and confirmed your 2016 health plan selection by December 15, you'll get a notice from the Marketplace between December 16 and January 1. It will tell you you've been automatically enrolled and explain your options for updating and changing health insurance plans.

Just log into your Marketplace account as soon as possible and make the updates to your 2016 application.

When you update your expected income and household changes for 2016, you'll get updated eligibility results. Your premium tax credit and other savings may change. You could also qualify for different coverage.

Important: After you get updated eligibility results, you must finish the process and enroll in a plan – even if it's the one you already have. If you don't, your insurance company won't get your updated information.

You can change plans only until January 31, 2016. After then, you can't change plans for the rest of 2016 unless you qualify for a Special Enrollment Period.

 
 

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