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Open Enrollment

Whether you are getting a health insurance plan for the first time or you want to replace the one you have, it’s important to know when you can sign up for or make changes to your health coverage. Here’s what you need to know about these periods, called open enrollment, and what happens if you miss them.

When Is Open Enrollment? 

If you are in the market to buy a private health plan, you will be able to do so through the Health Insurance Marketplace during an official open-enrollment period.

Open Enrollment for 2019 runs from November 1st, 2018 through December 15th, 2018.

You can apply for Medicaid or the Children’s Health Insurance Program through the Marketplace at any time.

What's New for 2019?

Many health plans have made changes to their marketplace offerings for 2019. Please find below the most current information that is available.  We will update all insurance information for 2019 as soon as that information is available along with NorthShore’s participation.

  • Blue Precision HMO - NorthShore will participate for 2019 (verify PCP participation)
  • Blue Choice - NorthShore DOES NOT participate
  • Cigna Connect - NorthShore DOES NOT participate
  • Ambetter - NorthShore DOES NOT participate

What Is a Special Enrollment Period? 

There are a few circumstances in which you may be able to enroll or change your health insurance plan outside of the official open-enrollment period. If you have certain so-called qualifying events occur, you may be eligible for what’s called a special enrollment period. Pre-enrollment verification is required for special enrollment periods. Documentation must be submitted that proves eligibility for the special enrollment period before consumers are allowed to enroll in marketplace coverage. 

These events include:

  • Moving to a new state
  • A change of income
  • Marriage, divorce or a new baby

In most cases, the special enrollment period runs 60 days from the qualifying event.

What Happens if I Miss the Deadline? 

If you miss the open enrollment deadline and you are without a health plan for 2019, you will not have to pay a penalty fee. However, if you did not have minimum essential coverage for 2018, you may still owe payment when filing your taxes in 2019.  This fee is called the individual shared responsibility payment.

For lack of coverage during 2018, you pay the higher amount of either:

  • 2.5 percent of your household income  or
  • $695 per adult and $347.50 per child under 18 (up to $2,085 per family) 

There are some situations in which you might not have to pay the fee for being uninsured. For example, if you:

  • were uninsured for less than three consecutive months
  • don’t file taxes because your income is below the tax filing threshold

  •  

    weren’t able to find a health plan that costs less than 8 percent of your household income 
  • are American Indian
  • had religious reasons for not purchasing insurance
  • had financial hardship
  • are a member of a Health Care Sharing Ministry

For one-on-one help applying for health coverage through the Marketplace, visit http://localhelp.healthcare.gov.

Last updated: October 2018