Definitions for Special Enrollment Period Information
Affordable Care Act – The Patient Protection and Affordable Care Act, commonly known as Obamacare, is the law that was signed in 2010 under President Obama. This law requires a multitude of things, but arguably the most important parts are:
- Every health plan must have the 10 essential benefits;
- Everyone must have health insurance, or pay the penalty; and
- Every health plan must be “affordable”
Another part that continues to confuse consumers is that there is now an Annual Open Enrollment Period, during which consumers may choose a health plan for themselves and their families. Outside of that Open Enrollment Period, consumers will need a qualifying life event to enter a Special Enrollment Period, which is the only way to switch plans or enroll outside of Open Enrollment or an employer’s health plan.
COBRA Insurance – The Consolidated Omnibus Budget Reconciliation Act of 1985 (or COBRA) is a law passed by the U.S. Congress. It is not an insurance company. This law requires employers with 20 or more employees and a group health plan to offer those who lose that coverage a continuation of that health plan at their own expense. In order to qualify, you need to experience an event like getting fired, laid off, quitting your job, divorce, or retiring. (For more information on COBRA, visit www.cobrainsurance.com)
Open Enrollment – The period of time during which consumers can switch or enroll in a qualified health plan. For 2014, Open Enrollment ended on March 31st, but for 2015 Open Enrollment, it begins on November 15, 2014 and ends on February 15, 2015. Outside Open Enrollment, if a consumer would like to change their plan or enroll, they will need a qualifying life event to trigger a Special Enrollment Period.
Premium – The amount that must be paid for your health insurance or plan. You and/or your employer usually pay it monthly, quarterly, or yearly.
Qualifying Life Event – A change in your life that can make you eligible for a Special Enrollment Period to enroll in health coverage. Examples include having a baby, getting married, or moving to a new coverage area. For a full list of Qualifying Life Events, click here.
Special Enrollment Period – A time outside of the Open Enrollment Period during which you and your family have a right to sign up for health coverage. Generally, Special Enrollment Periods last for 60 days from the date of the event. If you don’t have a qualifying life event, you can’t purchase insurance outside of the Open Enrollment Period. For a full list of Qualifying Life Events, click here.