During open enrollment, employees tend to ask a lot of questions about the benefits and their options. Now that the exchange plans are available in the Individual Marketplace, employees will naturally have questions about the plans available and if they can move their coverage or their dependents’ coverage to save money.
There are a few things to be aware of when providing the employee with information about the marketplace.
- The open enrollment period for Connect for Health Colorado is November 15, 2014 to February 15, 2015 for coverage that begins January 1, 2015.
- Since coverage is now guaranteed issue, enrollment is ONLY allowed during this open enrollment period OR when an individual has a qualifying event (QE).
- QEs create a 60 day Special Enrollment Period (SEP) when individuals and families have the right to sign up for coverage.
What constitutes a Qualifying Event (QE) on the exchange?
- Birth, adoption or placement for adoption of a child
- Change in Marital Status due to marriage, death of spouse, divorce, legal separation or annulment
- Moving to Colorado
- Change in citizenship or incarceration status
- Involuntary loss of health coverage (loss of job-based coverage, COBRA expiration, aging of parent’s plan, loss of student coverage, losing eligibility for Medicaid or CHIP)
- Voluntarily ending of employer coverage if and only if that coverage qualifies as a minimum essential coverage, AND the ending of coverage is at the employer’s open enrollment effective date. Note that if the employee is opting out of “affordable” coverage, they will not be eligible for a tax credit on the exchange.
These rules can be complex and employees may have questions beyond what you can answer. This email address is being protected from spambots. You need JavaScript enabled to view it.
