As you know, the first two enrollment deadlines for 2016 coverage have come and gone. During these last couple of weeks of the annual open enrollment period, people can sign up for coverage to begin on March 1st. We know you’re busy trying to sign up as many people as possible in the last few days, so we’ll keep this short, but we did want to share a couple items with you that may help you better advise your clients and bring in a few more sales.
The Penalty for Not Signing Up
Cost has been a big concern for people this year, especially for individuals not eligible for a premium tax credit. That may have caused them to drag their feet and wait to sign up. If you run into someone who’s on the fence about buying coverage this year, you may want to remind him or her that the penalty for going without health insurance in 2016 is pretty high. It’s the greater of these two amounts:
- $695 per adult and $347.50 per child (with a cap of $2,085 per family)
- 2.5% of the applicable household income (capped at the 2016 national average premium for a bronze-level plan).
It’s no longer a “weak” individual mandate. On top of that, going without coverage could lead to big medical bills, so be sure to remind folks that this is their last opportunity to get health insurance this year; they can’t wait until they get sick to sign up.
Exemption for a Short-Term Gap in Coverage
If your prospects think it’s already too late to avoid the penalty in 2016, you may want to inform them that there’s an individual mandate exemption for people who have a single short-term gap in coverage of two consecutive months or less. To apply for an exemption, they’ll complete IRS form 8965 when filing their 2016 taxes.
No Tax Period Special Enrollment Period
Last year, there was a special enrollment period for those who first learned about the individual mandate when filing their 2013 tax return and were going to be penalized. The government has said that there will be no similar special enrollment period this year. For most people, this truly is the last opportunity for 2016 coverage.
Expect a Last-Minute Surge
The open enrollment period ends January 31st, and you should expect a surge of last-minute enrollees. A lot of people wait to do stuff—especially stuff they’re not excited about—until the absolute deadline. We see it every year on April 15th, and we’re starting to witness the same thing with health insurance enrollments. There were so many people trying to sign up for coverage on December 15th that the government extended the January 1st enrollment deadline by two days, but there’s no way to know if they’ll do that again at the end of January. It’s best not to count on it.
Instead, you should sit down today and figure out how you’re going to budget your time for the last few days of open enrollment. Try to help as many people as possible, but push them to make a decision because you don’t have time for multiple conversations—and neither do they. In February, you can start circling back with some of these enrollees to tell them about any other products you offer that may help fill some of the gaps in their new health coverage.
Good luck to you, and let us know if AHCP can help.