Rhodes-Warden Insurance Blog

All You Ever Wanted to Know About Insurance

Health Care Enrollment - Get The Facts

By now, most of us are familiar with Obamacare and the changes it has made in our country’s health care laws.  One of the most far-reaching changes was the Individual Mandate that requires most Americans to have health insurance coverage or pay a penalty when you file your taxes.  Since we’re in the midst of the 2014 tax filing season, this seems like a good time to review the facts. 

The penalty for not having health insurance is referred to as the “Shared Responsibility Payment” and for 2014 it is the higher of $95 or 1% of your income above the filing threshold.  For 2015 it is $325 or 2%.  There are a few exceptions, primarily for people with low income.  If you have health insurance coverage through the company you work for or are enrolled in Medicare/Medicaid, then you already satisfy the requirement. 

When it comes to purchasing health insurance coverage, an important time of year is the annual Open Enrollment Period.  For coverage beginning in 2015, the Open Enrollment Period ran from November 15, 2014 to February 15, 2015.  If you don’t have health insurance and didn’t purchase any during this past Open Enrollment period, you’ll most likely have to wait until the next open enrollment starting November 15, 2015 through February 15, 2016. 

Even though the open enrollment has ended for this year, there are certain “qualifying events” that will allow a person to purchase health insurance coverage outside the open enrollment period.  This is referred to as the “Special Enrollment Period” (SEP).  These qualifying events include getting married or divorced, having a baby or losing your current health insurance coverage.  There are other situations in which you can purchase coverage during the Special Enrollment Period, so be sure you stay informed.  You may also be able to enroll for health coverage outside the Open Enrollment Period due to some recent rule changes: 

Tax Season Special Enrollment – Some individuals didn’t know of the tax penalty until filing their 2014 taxes.  They will be allowed a special enrollment period of March 15th through April 30th 2015 in which to enroll through the federal marketplace, Healthcare.gov.  They will still pay the penalty for the months in 2014 and 2015 when they had no health coverage, but by enrolling in a health plan, will avoid more fees when filing their 2015 taxes next year. 

Extension – Some insurance companies selling health insurance policies in Oregon requested an extension that allows them to sell policies until April 30, 2015.  Again you could still be paying the penalty for the months you were not covered.  Please sure to contact our office at (541) 258-2131 for more information on this. 

Other Options –Oregon has taken part in the expansion of Medicaid eligibility that allows more lower income individuals to qualify for aid.  The Oregon Health Plan allows year-around enrollment based on income.  You can find out if you qualify and enroll for health coverage through the federal marketplace, Healthcare.gov.

Understanding the changes our new health care form law presents and how they affect you can be complicated. Here at Rhodes-Warden Insurance, we understand the new law and have been preparing for it since its passage in 2010. We are here to help make purchasing your health insurance coverage a little less stressful during the next Open Enrollment period or your Special Enrollment. If you have any questions or would like to more information about how to purchase coverage, please contact one of our office located in Lebanon, Albany or Stayton,Oregon.

While every attempt has been made to ensure the accuracy of all information as of the publication date, the information provided is subject to change. Federal and state rules and interpretations of the Affordable Care Act (ACA) also known as Obamacare continue to evolve, and every individual’s or employer’s circumstances are unique. Please consult with your own legal and tax advisors for advice.