Obamacare Q&A: Exchange deadlines, insurance options and tax credits

March 31 is the deadline for buying insurance through the exchanges created by the federal health law. And although much about the law commonly known as Obamacare has changed in recent months, federal officials have indicated  that the deadline isn't moving.

Here’s what you need to know about the end of the 2014 open enrollment period, the insurance options you'll have once it's over, when you’ll face a penalty if you don’t get covered, and the possibility of getting federal financial help buying a health plan outside the exchange.

If you have a question about Obamacare, email Mirror health reporter Arielle Levin Becker at alevinbecker@ctmirror.org.

If I don’t buy insurance by March 31, can I still get covered this year?

Unless you qualify for an exception (more on that later), you won’t be able to buy an individual market health insurance plan in Connecticut in 2014 if you miss the March 31 deadline. That applies to both the exchange and the insurance market outside the exchange.

Aetna, Cigna, ConnectiCare, HealthyCT and Anthem Blue Cross and Blue Shield all said they will not sell individual policies for this year after March 31.

There is an exception to the March 31 deadline, for both the exchange and the private companies that are using the same deadline for their off-exchange plans: something called a “qualifying event.” Those include moving to a new state, certain income changes, getting married or divorced, or having a baby. In those cases, people could enroll in health care coverage, even if it’s outside the sign-up period for the general public.

People who qualify for Medicaid can enroll at any time during the year. The deadline does not apply to small-group insurance plans.

(Note: Because of incorrect information from the companies, an earlier version of this story said Aetna and HealthyCT would continue selling plans after March 31. People will only be able to buy Aetna and HealthyCT plans after that date if they have a qualifying event.)

If I buy coverage outside the exchange in June, would that get me out of paying the penalty?

No, you’ll still be penalized. But getting coverage at some point in 2014 would reduce the size of your fine.

The penalty for not having coverage in 2014 is $95 or 1 percent of your income above the tax return threshold, whichever is higher. (The tax return threshold varies depending on filing status, but is around $10,000 for a single person and $20,000 for a married couple filing jointly.)

Although the $95 figure gets most of the attention, for most people, the penalty will be 1 percent of their income.

But you’ll only pay the full amount if you’re uninsured for a full year. Otherwise, you’ll pay a prorated penalty based on the number of months you go without insurance.

What’s the deadline for avoiding the penalty?

This year, you won’t face a penalty as long as you sign up for coverage through the exchange by March 31.

People who sign up for coverage through the exchange after March 15 won’t get coverage until May 1. Based on federal regulations, that would leave them subject to the penalty anyway, since people who are uninsured for three or more months would face the fine. So the federal government is allowing people who sign up for an exchange plan by March 31 to avoid the penalty.

Next year’s open enrollment period for federally run exchanges is scheduled to run from Nov. 15 to Feb. 15, so the same issue won’t arise. Because Connecticut's exchange is state-run, its open enrollment period could have different dates. Stay tuned.

Can I get subsidies for off-exchange plans?

In general, the federal tax credits to subsidize the cost of premiums is available only to people who buy their insurance through the exchanges.

But late last month, the federal government issued guidance indicating that people could get federal assistance paying premiums on plans purchased outside an exchange if they weren’t able to enroll in a health plan through the exchange because of the exchange's technical issues. For people in that situation whose incomes made them eligible for subsidies, the federal government could provide subsidies retroactively. They would also be given a chance to enroll in coverage through the exchange.

Could that happen in Connecticut?

Kevin Counihan, CEO of Access Health CT, the state's exchange, said it’s up to each state whether to make the option available to residents. But he said it’s aimed at states that have had significant problems with their exchanges.

“I think it’s not really intended for states where the functionality’s been working fairly well,” he said.

Translation: It’s probably not for Connecticut.

Counihan said the exchange staff planned to meet with state officials about the issue.

More In This Series
Obamacare: Continuing Coverage

Follow The Mirror's coverage of the Affordable Care Act in Connecticut. Find features, explainers and Q&As to better understand how the complex policy changes taking place under Obamacare are supposed to work in theory, and how they're working out in practice.

About Arielle Levin Becker

Arielle Levin Becker was a finalist in 2009 for the prestigious Livingston Award for Young Journalists, a recipient of a Knight Science Journalism Fellowship and the third-place winner in 2013 for an in-depth piece on home caretakers from the National Association of Health Journalists. Arielle previously worked for The Hartford Courant, most recently as its health reporter. She also has covered education and municipal beats for The Courant and for the Home News Tribune of East Brunswick, N.J. She is a 2004 graduate of Yale University. E-mail her at alevinbecker@ctmirror.org.

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