Open Enrollment for 2017 Plans – For coverage starting in 2017, the Open Enrollment Period will be November 1, 2016 through January 31, 2017. Individuals may be eligible for Special Enrollment Periods (SEP’s) outside of Open Enrollment if they experience a qualifying event. If individuals do NOT have a SEP, they CANNOT buy health insurance outside of open enrollment. Cancellation for non-pay is not a SEP.

2017 Penalty – The penalty for not having any insurance in 2017 is the same as in 2016. That penalty is $695 per adult ($347.50 per child under 18) or 2.5% of household income, whichever is greater. This is the maximum penalty but it can rise each year based on inflation.

Review of Healthcare Reform Plans:

  • “On Exchange” is primarily for individuals that would be eligible for a subsidy from the government to help pay their insurance premiums. The amount of the subsidy depends on household size and how many are enrolling in the plan. There are fewer insurance companies that offer plans On Exchange and the networks used are “narrow networks” (mainly HMO’s).
  • “Off Exchange” would be very similar to how an individual bought health insurance prior to healthcare reform except that all of the plans offered are healthcare reform compliant (cover the Essential Health Benefits) and they are more expensive. You have more insurance companies and more plans to choose from Off Exchange.
  • Individual plans are guarantee issue, no health questions asked, and there are no waiting periods for pre-existing conditions. Rates are solely based on age, where you live, and tobacco use.

Michelle Cole & Associates, Inc. represents many health insurance companies in Georgia, including: Blue Cross Blue Shield of GA, Aetna, Coventry, Humana, Alliant, and United Healthcare. This allows us to provide the best coverage for each individual member. Below are key notes regarding the primary players for this year’s upcoming open enrollment.

  • United Healthcare will NOT be selling individual plans on or off exchange (in GA) in 2017. Anticipated financial losses for the year are currently around $650 MILLION (nationwide). They are also currently planning to pull out of the exchanges for at least 15 other states.
  • Aetna is projecting over $300 million in losses for the year (nationwide) and will continue to opt-out of participating on the exchange.

The staff at Michelle Cole & Associates, Inc. is here to help you with your health insurance needs. No matter what your family situation or income may be, we can help you find the right coverage for you and your family. Call or email us for help!