I just want to keep my same health insurance plan
And other common questions you may have about Open Enrollment Period.
Did you know that health insurance plans change, every year? You've probably heard it before, and advertised on your news feed - "Open Enrollment is Coming!" But what exactly is Open Enrollment and why should you care?
We've put together a list of the most common questions we get each year and what you can expect during the process. These questions are specifically for those with an ACA plan aka Marketplace plans, Obamacare plan or plans purchased on healthcare.gov.
What is Open Enrollment?
Open Enrollment Period, or sometimes referred to OEP, is the one time of year that anyone can buy or change their health insurance plan. If you don't buy a plan during OEP you won't be able to unless you have a qualifying life event. If you already have a health plan, OEP still applies to you! This is the one time of year you can change your plan unless you experience a qualifying life event (ie you move).
OEP is also the time to update your subsidies. Subsidies are the amount of help you get paying towards your health insurance premium. Even if everything on your application is staying the same including income, household size and zip code, the amount of subsidies will change every year and need to be updated on your plan. If this does not get updated on your application each year, you may have to pay back any extra subsidies you got at tax time.
When is Open Enrollment?
OEP for the 2023 plan years is November 1st through January 15th. But if you want your new plan to start January 1st, you must have your application in before December 15th. This may seem like a short time to choose a health plan, but don't worry, our local agents will make the process smooth and easy!
Why does Open Enrollment exist?
If an Open Enrollment Period didn't exist, when would you buy health insurance? Most likely when you got sick or injured, right? By limiting when you can purchase health insurance, the amount of premiums being paid to health insurance companies remains relatively stable. This allows insurance companies to maintain a balanced pool of sick and healthy people, keeping the marketplaces stable. If people could sign up for insurance at any point, there would be an unhealthy disruption within the health insurance industry.
Who can sign up during Open Enrollment?
Those that live in the United States and are any of the following: a U.S. Citizen or national or be lawfully present in the U.S. There are many types of documents that are accepted for eligible immigration status. Talk to one of our local agents to see if you qualify (most likely you do!). There are a few circumstances that will disqualify you for a health plan with subsidies including incarceration, be eligible for Medicare or certain other health plans. Most families will qualify for lower premiums, contact us today to see if you qualify.
Can I just keep my same plan?
You really liked your current plan, so why can't you just keep it year after year? The main reason is that plans on the Marketplace are only good from January 1st through December 31st. Every health plan changes, including the deductible, copays, and maximum out of pockets. Sometimes the changes are little, but you'll want to be sure that you know what is going to change. Also, new plans with different benefits become available every year. You'll want to make sure that you have the best plan that fits your needs because your needs may change year to year as well.
The other reason you'll want to update your plan year to year, is the amount of subsidies that you get towards your plan will change and you'll want to make sure that you have the updated subsidy amount on your application to avoid any penalties at tax time.
Why is the Marketplace calling me?
As you may have already noticed, you probably received emails, phone calls or letters from the Marketplace or healthcare.gov about OEP. They do that because they do not want you to miss your OEP opportunity to re-enroll in a health plan. They may also call you because you may need to submit further documentation to verify your income, citizenship or immigration status. As your agent, we take care of this for you. We help you enroll in a plan and we can submit all the required documentation for you and will contact you if anything further is needed.
If we are your agent and you do get any further notices or calls about OEP, documentation, citizenship or immigration status, let them know your agent is handling it, and hang up. PLEASE DO NOT MAKE ANY CHANGES OR SUBMIT ANY DOCUMENTS directly to healthcare.gov as this may adversely affect your coverage.
I just started my plan, why do I need to do it again?
If you've recently signed up for a health plan in September through December, your plan, subsidies, deductible, copays and benefits will still change and reset on January 1st 2023. You local agent will help you enroll in a plan for next year with the best benefits.
I just got an email saying I need to pick a plan, what do I do?
The Marketplace or healthcare.gov will send out notices as we get closer to OEP and during the OEP. They send these notices to everyone who currently has a plan and those that had plans in previous years. Do not respond to these emails from healthcare.gov. Utah Avenue Insurance will send you emails about the best plans for you that you can choose from. See below in the "What is the process for open enrollment" section.
What information will I need to re-enroll in a health insurance plan?
You'll only need to give us any information that will be changing in the next year. The most common changes are the following:
Income: Are you getting a raise, changing jobs, working more hours, starting a business, contributing more to a retirement fund, starting to taking social security income, starting to draw from a pension or 401k, or going to stop working in the next year? Let your agent know what changes in income you'll have next year. Income amount is one of the biggest factors in how much you pay for your health insurance plan. If we get your income on your application wrong you may need to repay some of the extra subsidies.
Household Size: Your health insurance plan can only include those who are included in your taxable household in order to be eligible for subsidies. If you have more or less people on your application, you may have to payback some of the extra subsidies you got on your health plan.
Pregnancy: Let us know if you are currently pregnant or are trying to get pregnant. Your local agent wants to help you save money when it comes time to pay for labor and delivery costs. Plus if you are adding a person to your household in the next year, you can get lower premiums through the entire year.
Split Households: Your local agent also needs to know if you are not claiming all your children on your tax return. Many families who have gotten divorced with children will claim certain children and specific years. Please let your agent know who you are going to be claiming and who needs health insurance. Your local agent may need to get children that you do not claim on your taxes their own health insurance plan.
Moving: If you are moving to another location within or without your state, please let your agent know. Your plan options, pricing and benefits may change when you move. Let your local agent know so that you can know how your plan will change.
Marriage or Divorce: Let your agent know if you are getting married or divorced in the next year. This may change how many subsidies that you get on your health insurance plan. Your local agent wants to help you avoid paying back any extra subsidies that you got on your health insurance plan.
Change in your Health: Please let us know if you are seeing a new doctor, got a new diagnosis, taking a new medication, or have an upcoming surgery. Your local agent can help make sure you are on the right plan that saves you the most when you need care.
Do I need to update or change my dental insurance?
Nope. Some insurance plans like dental insurance, vision insurance, life insurance and accidental insurance do not need to be updated year after year. But if you've had changes, like you need extra dental work done next year, let your agent know so they can make sure you're on the right plan. These extra plans can be updated, purchased or changed at anytime. You do not need to wait for open enrollment.
What is the process for Open Enrollment?
Your local agent at Utah Avenue Insurance has made OEP easy and smooth. It's our pleasure to research the over 100 new plans on the marketplace, changes in subsidies, networks, copays, and all the things, so that you don't have to. Here's what you can expect from us to make the process simple.
Annual Policy Review Email. This email will ask a few short questions about how you liked your current health plan, any changes you may have (like if you're pregnant, moving or are taking a new expensive medication) This should take about 5 minutes. This give us all the best info so we can research the best plan options for you as soon as we get rates for the next year.
Sneak Peek at Rates Email. This email will give you a sneak peak at your best options for next year's health insurance plan. It will go over premiums, deductibles, copays and more. If you like what you see, you can approve your new plan right in that email! If you would like to make changes, you can schedule a time to speak with your agent. We have phone, in-office, and virtual appointments available.
Approve Your Plan. After we've made the right changes and helped you pick the right plan for you and your family, you need to approve your plan. Each year you'll sign the authorization form that approves your plan and allows your agent at Utah Avenue Insurance to keep being your agent.
Your agent does your application for you. You may get multiple emails in this process from healthcare;gov. You can ignore those emails and rest assure that we have everything taken care of. Occasionally, the Marketplace will ask for documentation on income or citizenship, but your local agent will let you know if we need to submit anything.
Premium Payments. If you are staying with the same health insurance company and your currently set up on autopay, then your premiums will be taken out of your account and the regularly scheduled time. If you are new to a health plan or are switching companies, you'll need to let your local agent know when to schedule the first payment and set up autopay. The first payment needs to be done before your plan starts. The best time is when your agent completes your application. This ensures that your ID cards will arrive at the soonest time.
New ID Cards are Sent. New ID cards will be sent in the mail within the first 2 weeks of the new year. If you do not get new ID cards by then, please contact your local agent so they can verify your mailing address and get new cards sent out. Your local agent can also provide you with your ID number incase you need to go to a doctors appointment before your plan begins.
I just got a call asking for my citizenship and I'm not a citizen?
As you may have already noticed, you probably received emails, phone calls or letters from the Marketplace or healthcare.gov shortly after you enrolled in your plan. Please tell them that your agent is helping you with this and HANG UP. They do that because you may need to submit further documentation to verify your income, citizenship or immigration status. As your agent, we take care of this for you. We can submit all the required documentation for you and will contact you if anything further is needed. If we are your agent and you do get any further notices or calls, let them know your agent is handling it, and hang up. PLEASE DO NOT MAKE ANY CHANGES OR SUBMIT ANY DOCUMENTS directly to healthcare.gov as this may adversely affect your coverage.
Need assistance? We're here to help!
Whatever your situation, YOU QUALIFY for health insurance. Text or call us at 801-609-8699 with any questions or to get a free quote. You can also schedule an appointment to speak with an agent.
About Utah Avenue Insurance
Utah Avenue Insurance is your local health insurance experts. Our agents are here to help you with all your health insurance questions. Utah Avenue can help you with marketplace (aka Obamacare) plans, private health insurance and Medicare. If you have questions about how your medical insurance plans work or need help enrolling in a plan, we can help you. As always, our service is free to you.
Give Utah Avenue a call or make an appointment with Utah Avenue Insurance and we'll be happy to help!