If you are looking to obtain health insurance for the first time, or you want to change the insurance you currently have, Open Enrollment is the time to make that happen.
This time of year, known as the Open Enrollment Period, is the yearly period when people can enroll in a health insurance plan. Under normal life circumstances, you are not able to enroll in a new plan at any other time during the year.
Open Enrollment Period Explained
For most individuals, the Open Enrollment Period is the brief window that they must act to secure health coverage for the upcoming year.
The 2021 Open Enrollment Period for California runs from Sunday, November 1 to Sunday, January 31, 2021. It’s important to keep in mind that, like each prior year, the 2021 Open Enrollment Period only occurs for a few months. The plan you choose during Open Enrollment will start on January 1, 2021.
Two dates to keep in mind are December 15, 2020, and January 31, 2021.
- December 15, 2020, is the last day to keep your current plan in 2021 or to make changes for coverage that begins January 1, 2021.
- January 31, 2021, is the last day to make any changes for coverage beginning February 1, 2021.
If you don’t act by January 31, you won’t be able to get 2021 coverage unless you qualify for a Special Enrollment Period.
What is a Special Enrollment Period?
If you have a “qualified life event” you can sign up for health insurance outside of the Open Enrollment Period. A qualified life event is treated as an exception to the regular sign up restrictions. It allows you or a qualified family member to enroll for an individual or family health plan.
So, what are considered qualified life events?
A qualifying life event, or QLE, is a circumstance that has occurred within the last 60 days of applying for coverage. The 60 days are counted from the date the application is submitted.
Some of the most common life events are:
- Involuntary loss of health insurance
- Permanently moved to/within California
- Had a baby
- Got married
- Entered a domestic partnership
- Returned from active duty military service
- Released from incarceration
- Gained citizenship/lawful presence
Each QLE carries some strict guidelines in order for it to qualify you for a special enrollment period.
Open Enrollment: What You Should Know
When it comes to acquiring health insurance you only have a small window of time every year to enroll in a new medical plan. This is called the Open Enrollment Period. During this period you can also just renew your current plan, or make changes, such as adding dependents.
In California, health insurance plans are categorized as “on-exchange” and “off-exchange.” Buying a plan on-exchange refers to buying a plan directly through your state government exchange, which is known as Covered California. When you purchase a health plan off-exchange it means you are enrolling in a plan directly through an insurance carrier, or broker, such as J.C. Lewis Insurance Services.
For those who qualify, an alternative to purchasing a health plan directly from an insurance carrier in California is the Covered California Marketplace. This may be their best option for purchasing health insurance.
Individuals, families, and small business owners who qualify can receive tax credits known as Advanced Premium Tax Credits. These are applied toward their monthly insurance premiums for health plans from carriers participating in the marketplace.
For individuals and families, Covered California includes the following carriers for 2021:
- Blue Shield of California
- Anthem Blue Cross
- Health Net
- Western Health Advantage
- Kaiser Permanente
Most health insurers in California use some sort of open enrollment program. But there are a few exceptions:
Medi-Cal
Medi-Cal doesn’t limit enrollment to the Open Enrollment Period. If you’re eligible for Medi-Cal, you’re allowed to enroll anytime. If your income is below 128 percent of the Federal Poverty Level, you qualify for Medi-Cal, which is Medicaid for Californians.
CHIP
The Children’s Health Insurance Program doesn’t limit enrollment to a specific time, either. CHIP provides low-cost health coverage to children in families that earn too much money to qualify for Medi-Cal.
Your Local Health Insurance Experts, Ready to Serve You
We are J.C. Lewis Insurance and we’re a long-time, family-owned firm made up of expert brokers, based here in Sonoma County. We offer California health insurance plans from only the leading health insurance carriers that are licensed to do business in California.
We are licensed and certified by each of these California health insurance carriers to offer coverage to individuals, families, and small group employers, in addition to Medicare supplemental and prescription drug plans for seniors.
As experienced, professional local insurance brokers, we are ready to help you with your health coverage needs. If you are self-employed, or your employer doesn’t provide health benefits, an individual or family plan can be the best option for you, or you and your family.
When you’re looking for medical insurance for you and your family, you are likely to have a number of questions and concerns. That’s great because we welcome your questions about health coverage insurance, and you can be confident that J.C. Lewis Insurance Services will help you find the right solution.
