You may have heard the rumors, but now it’s official: the open enrollment period in the individual market has been extended to January 15 in states that use the Federally-Facilitated Marketplace (Healthcare.gov). The new end date was announced by CMS in a September 17th update to the 2022 Notice of Payment and Benefit Parameters.

The new end date expands the open enrollment period from 44 to 75 days, giving agents more time to sell individual business and freeing up some time during the busy season to help other clients, like those who need a Medicare Advantage or Medicare Part D plan. The annual election period for Medicare runs from October 15 to December 7, and the overlapping enrollment periods often cause agents to choose between one market segment and another. 

While the new rule applies to the Federally-Facilitated Marketplace. “State-based exchanges with their own eligibility and enrollment platforms will be able to set their own annual Open Enrollment Period end dates, so long as these dates are on or after December 15, 2021.”

The CMS announcement was accompanied by a fact sheet that provides additional details about the updates to the final rule. In addition to the extended open enrollment period, which applies to “2022 and future benefit years,” there are several other changes:

• The rule restores and expands the duties of Navigators, who help “vulnerable and underserved populations…find affordable coverage that meets their needs.” There will be 1,500 Navigators available for the 2022 enrollment season, about four times last year’s number. 
• Marketplaces will have the option of creating a monthly special enrollment period for consumers with incomes below 150% of the federal poverty level.
• The rule clarifies that “enrollees who qualify for a maximum APTC amount of $0 are eligible for an SEP based on a change that makes them newly eligible for an APTC amount greater than $0 (based on a decrease in their household income, for example).”
• “The rule repeals the separate billing regulation that required individual market qualified health plan (QHP) issuers to send a separate bill for that portion of a policyholder’s premium attributable to coverage for abortion services for which federal funding is prohibited.” Instead, QHP issuers will “have flexibility in selecting a method to comply with the separate payment requirement under section 1303 of the Affordable Care Act (ACA).”
• The rule rescinds 2018 guidance on section 1332 waivers and finalizes new policies aimed at “empowering states to develop innovative health coverage options that best fit a state’s individual needs, expand coverage to its residents, and lower costs.”

We’ll wrap this up with two quick reminders:

1. The open enrollment period begins November 1. If you haven’t completed your Marketplace training yet, be sure to do that asap. 
2. Also, now is the time to get appointed with any carriers you don’t currently work with who might be able to help your clients this fall. You can find a wide range of solution providers on the carrier page of the AHCP website. There is a separate page for agents who market Medicare-related products. Or call AHCP at 877-228-8773