Similar to last year’s open enrollment, the federally facilitated marketplace (FFM) will automatically renew consumers into coverage if they do not go back to the marketplace to update their information and select a plan. This means that eligible consumers will be automatically re-enrolled into coverage and receive a redetermination of their eligibility for 2016 premium tax credits. This year the marketplace will be making 2016 eligibility determinations for premium tax credits based on 2016 premiums, updated federal poverty guidelines and the most recent available income information. If eligible consumers take no action by December 15, 2015, the FFM will automatically renew them so that they will have continuous coverage and financial assistance starting on January 1, 2016.
Although the auto-renewal option is available, all consumers should go back to the marketplace to shop for the following reasons:
- Price changes. According to the Centers for Medicare and Medicaid Services (CMS), the average price of benchmark plans in 2016 has increased 7.5 percent across the FFM states, but with dramatic differences among states and insurers. Approximately 58 percent of eligible consumers will see a different insurer with the lowest cost silver plan. So in most markets, there will be a new benchmark plan for 2016 with a different price. Since the premium tax credit amount is pegged to the price of the benchmark plan, the value of their premium tax credit will change in 2016 for most people unless they shop for a new plan.
- Health plan changes. Health plans can change their provider networks and benefit design year to year. If having a doctor or hospital covered by your health plan or having a particular drug covered is important to you, make sure to check with the health plan to confirm that your care will be covered.
- Cost-sharing reductions. If your household income is between 100 to 250 percent of the federal poverty level (between $11,770 and $29,425 in annual income for a household of one), you’re likely eligible for cost-sharing reductions. This means you may qualify for a health plan with little or no deductible and more modest out-of-pocket expenses. You can ONLY get cost-sharing reductions if you select a silver-level plan.
- Savings. A recent report about shoppers and switchers from the 2015 open enrollment season shows that people that switched health plans in the same metal tier saved an average of $33 per month or nearly $400 for the year compared to what they would have paid if they stayed in the same plan. People that switched insurance companies saved even more.
- Income and household changes. To make sure you get the most accurate amount of premium tax credit, make sure the marketplace has the most recent income and household information for you.
Below are some Frequently Asked Questions from our online Navigator Guide. You can find the answers under Section 2 at navigatorguide.georgetown.edu.
- I received a notice from the marketplace telling me I am not eligible for automatic renewal of my plan. What should I do? (FAQ 2.1.23)
- I like my health plan just the way it is. Will it stay the same in 2016? (FAQ 2.1.22)
- When should I return to the marketplace to renew my plan and update my eligibility for subsidies? (FAQ 2.1.19)
- I was automatically renewed by the marketplace and I just got my premium invoice for January. It’s way too high! What do I do? (FAQ 2.1.26)