The deadline to sign up for private insurance under the federal health law this year is long past, but some state residents who are currently uninsured will have a 30-day window to sign up for plans during April – if they meet certain criteria. Here are the details.
Who can sign up?
The special enrollment period is for people who are uninsured now, have not had coverage at all in 2015, paid a tax penalty for not having coverage last year, and didn’t find out about that penalty until they did their taxes.
People in that situation can sign up for private insurance plans through Access Health CT, the state’s health insurance exchange, from April 1 through April 30. (People who qualify for Medicaid can sign up at any point in the year.)
When will the coverage start?
People who sign up by April 15 will receive coverage starting May 1. Those who sign up from April 16 through April 30 will receive coverage beginning June 1.
Will this keep me from paying a penalty next year?
No, but it will reduce whatever penalty you might have to pay.
The health law allows people to avoid paying a penalty if they are uninsured for fewer than three consecutive months in a year. But if you didn’t have coverage at all this year and then sign up through this special enrollment period, you’ll have to pay for the months you didn’t have coverage. The penalty is prorated, based on the number of months you were uninsured, so if you get insurance in May or June, you’ll pay less than you would if you went without coverage for the full year.
The penalty for not having coverage for all of 2015 is $325 per person or 2 percent of household income – whichever is higher.
Some people are exempt from having to pay a penalty even if they are uninsured, including those whose income is low enough that they don’t have to file a tax return, people who belong to a health care sharing ministry, people who belong to a federally recognized tribe, or those for whom insurance is unaffordable (that is, if the cheapest option available costs more than 8 percent of household income).
Will I have to prove I paid a fine or didn’t know about the penalty until now?
No. People who apply for coverage during the special enrollment period will need to attest that they didn’t enroll in coverage and only learned they must pay a penalty through filing their taxes. But they won’t have to show proof. Those rules are in accordance with guidance the federal government issued for its exchange.
How do I sign up?
People can sign up online at www.accesshealthct.com, by phone at 1-855-805-4325 (the TTY line is 1-855-789-2428), or through the Access Health CT mobile app.
If I don’t sign up now but want insurance later in the year, can I sign up then?
No. After April 30, you won’t be able to buy private insurance for 2015 through the exchange.
There is an exception for people who go through certain life events that cause them to lose coverage or substantially change their eligibility. For example, if you lose your insurance because you get divorced, lose your job or you no longer qualify for Medicaid, you can sign up for private insurance within 60 days. Similarly, if you have a baby, you can sign him or her up for coverage instead of waiting until next year.
The next open enrollment period, when people will be able to buy health plans for 2016, begins Nov. 1 and runs through Jan 31, 2016.
For more information about health plan options, insurance and health care, see The Mirror’s guide to health care in Connecticut.