Got questions about Marketplace eligibility redeterminations and renewals during OE2? I’m pleased to report that CHIR’s Navigator Resource Guide has been updated with new background and frequently asked questions to help people better understand what they need to do and when. As with all the questions in the Navigator Guide, these FAQs were developed in collaboration with staff from Georgetown’s Center for Children and Families, the Kaiser Family Foundation, and the Center on Budget and Policy Priorities.
Here’s a sampling of the questions we’ve got the answers to:
- I received a notice telling me it’s time to renew my marketplace plan. What do I need to do?
- I signed up for a marketplace plan through a special enrollment period in July. Do I still have to renew my plan during the open enrollment period?
- I haven’t had any changes to my income or other family circumstances, and I want to keep my same plan. Why should I return to the marketplace?
- What happens if I don’t return to the marketplace to update my application?
You can check out the answers to these questions and more in Section 2, Chapter 1 of the Navigator Resource Guide, available here. The Guide and its regular updates are made possible thanks to a grant from the Robert Wood Johnson Foundation.
2 Comments
In your Navigator Resource Guide #167 you talk about an individual offered health insurance through his employer, but did not enroll. He is able to get insurance through the Exchange, but is not eligible for a subsidy.
In the large group market, insurance many times require 70% or 75% of the employees to enroll in order for the insurance company to issue a group plan.
My question is this: If a large employer offers coverage, but can’t get 75% of the employees to enroll, will those employees offered health insurance be able to get insurance through the Exchange, and will they be eligible for a subsidy?
Hi Alan. This quote from the preamble to the federal employer responsibility regulation may be of interest to you: “Commenters expressed concern about potential liability under section 4980H in the case of an applicable large employer that cannot obtain or maintain coverage for its employees because the employer cannot satisfy a health insurance issuer’s minimum participation requirements. In the large group market, a minimum participation requirement cannot be used to deny guaranteed issue. For small employers, such as relatively small applicable large employers, final regulations issued by HHS provide that an issuer must guarantee issue coverage to a small employer during an annual, month-long open enrollment period regardless of whether the small employer satisfies any minimum participation requirement. See 45 CFR 147.104(b)(1). HHS regulations generally define a small employer as one that has at least one, but not more than 100, employees. For plan years beginning before January 1, 2016, states may set the upper limit at 50 employees.”
Please also note that our Navigator Resource Guide has gone on-line: http://navigatorguide.georgetown.edu/. This searchable format allows us to keep the content updated to reflect evolving federal rules and policies. Thanks so much for your interest in CHIR’s work.