Obamacare Q&A: Deadlines, penalties and when to expect your insurance card
The new insurance plans available as part of the federal health law take effect in just over two weeks, and one of the first major deadlines of the law is less than a week away.
Meanwhile, many people who have already signed up for coverage are waiting for a bill for the first month’s premium or an insurance card to present when they get medical care. At Connecticut’s exchange, Access Health CT, about a third of the call center traffic last week came from people who had enrolled and were waiting for their premium statements, CEO Kevin Counihan said.
Here’s a look at some of the key dates for coverage under the law commonly known as Obamacare, what people who have enrolled should expect for the coming weeks, how to handle canceling old policies if you’re planning to switch to a new one and what happens if you don’t have coverage by Jan. 1.
If you have a question about Obamacare, email Mirror Health Reporter Arielle Levin Becker at firstname.lastname@example.org.
What are the important dates for getting coverage under Obamacare?
Dec. 23: Deadline to sign up for coverage through Access Health CT, the state’s health insurance exchange, if you want your insurance to take effect Jan. 1
Jan. 1: The first day plans sold through health insurance exchanges take effect. Any health plans sold or renewed on or after this date must comply with the requirements of the health law.
Jan. 15: Deadline for paying your premium for January coverage if you buy an Anthem Blue Cross and Blue Shield or ConnectiCare plan through Access Health.
Jan. 17: Deadline for paying your premium for January coverage if you buy a HealthyCT plan.
Note: Previously, the three insurers offering health plans through Connecticut’s exchange said they would accept January premiums through Jan. 7. More recently, the insurance industry announced that it was voluntarily extending the deadline to Jan. 10. The carriers later extended them past that date.
March 31: Deadline for signing up for coverage through the exchange if you want one of the insurance plans it offers in 2014.
I buy my own insurance and want to buy a new plan through the health insurance exchange. If I sign up now and pay for Jan. 1, when should I cancel my current policy? I am worried I will fall through the cracks and not have insurance.
You shouldn’t terminate your existing policy until you get written confirmation from the insurance company that your new plan will be in place and effective Jan. 1, said Tim Tracy, a Fairfield insurance broker and president of the Connecticut Chapter of the National Association of Health Underwriters.
People who sign up for insurance through the exchange should receive confirmation from the insurer and a bill for the first month’s premium, which must be paid for coverage to take effect. “You want to make sure that you have some sort of correspondence from the carrier…that states that yes, you’re going to be covered effective Jan. 1,” Tracy said.
Once a person has that, Tracy said, they can terminate their coverage with an effective date of Dec. 31.
State Healthcare Advocate Victoria Veltri also advised people getting new coverage that starts Jan. 1 to set their effective cancellation date at Dec. 31, as long as they have proof of coverage and premium, like a letter from the new carrier acknowledging enrollment and a bill for the first month’s premium.
As for paying that first bill, Veltri suggested that people use a credit card if possible to ensure they have a receipt of the payment. Those who pay by check should keep a copy of the check and consider sending it by certified mail, she said.
What happens if I don’t have coverage by Jan. 1?
Although most people who don’t have health insurance in 2014 will face a financial penalty, you still have some time to get insurance before getting penalized.
That’s because people who are uninsured for fewer than three months during a year aren’t subject to the penalty.
If you want to buy insurance through the state’s health insurance exchange, Access Health CT, for 2014, the deadline for doing so is March 31.
After that, you can only sign up for an exchange plan if you have what’s known as a “qualifying life event.” Those include: getting married, having or adopting a child, moving to a new area that offers different health plans, or losing access to other health coverage (for example, if you lose your job, get divorced or lose eligibility for Medicaid. Voluntarily giving up your coverage or failing to pay your premiums does not count).
If you already have a plan sold through the exchange, you could be eligible to enroll in a different one if your income or household status changes in a way that affects your eligibility for financial assistance for your premiums or cost-sharing.
If you qualify for Medicaid or the Children’s Health Insurance Program (both are known as HUSKY in Connecticut), you can sign up for those programs at any time because there is no fixed “open enrollment” period. However, you could face a penalty if you go without coverage for more than three months.
I’ve enrolled in insurance through the exchange. What happens now?
The exact sequence and timing depends on which insurance company you picked, but the basic process is that the exchange will make your enrollment information available to your insurer, which will send a bill. Once that’s paid, you’ll get an insurance card.
Access Health makes information available to insurers by putting the data on each enrollee on a secured server that insurers can use to collect the information. Access Health makes these data transfers twice a week.
If you picked a plan from Anthem Blue Cross and Blue Shield, the first thing you’ll get is a “premium initiation letter” — that is, your first bill. Those are sent out on a rolling basis, within 10 days of the company getting your enrollment information. Once you pay your premium, Anthem will mail you a member ID card and a welcome kit with information about your plan. Those get mailed within 10 days of Anthem getting your payment.
Anthem says that it can’t guarantee that members who apply after Dec. 15 will get their ID card by Jan. 1. But those who properly complete and submit their application by Dec. 23 are expected to have their policy effective Jan. 1 and coverage in place when the company gets their initial premium and determination of any subsidy that applies. If someone in that situation pays the premium by Jan. 10, the coverage will be in effect retroactive to Jan. 1.
The insurer HealthyCT sends customers an acknowledgement letter one to three business days after it receives the person’s enrollment information. Within three to five business days of getting the information, the company also sends out an invoice for the first month’s premium. A welcome kit and insurance card will be sent seven days from the receipt of payment. People who sign up for coverage by Dec. 23 have until Jan. 7 to pay their January premiums and receive coverage retroactive to Jan. 1.
ConnectiCare said Monday that people who apply after Dec. 15 are not guaranteed to get ID cards by Jan. 1. In addition, the company said it must receive payment for coverage to be effective, and will accept payment through Jan. 10 for January coverage.
On Thursday, ConnectiCare released the following schedule for sending out bills and ID cards, which is based on when people applied for coverage through Access Health CT (referred to below as “AHCT”):
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