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5 Changes to Open Enrollment for 2018 You Need to Know

5 Changes to Open Enrollment for 2018 You Need to Know

Posted Nov 02, 2017 by Jenifer Dorsey

Ready? Set. Enroll.

It is hard to believe, but this is the fifth ACA open enrollment period—and the fifth time we’ve had to adapt to a changing marketplace. To help make your 2018 open enrollment experience a bit clearer and easier, here are five things you should know.

1. The enrollment period will be significantly shorter this year—and possibly leaner in other ways, too.

If you need to purchase an individual health insurance plan for 2018, you will need to do it this calendar year. 2018 open enrollment begins and ends before the Christmas holiday in most states.[1],[2]

2018 open enrollment dates: November 1, 2017–December 15, 2017

Furthermore, half of all counties (51.43 percent) in the U.S. have only one insurance carrier participating in the exchange and the Trump administration decreased advertising and outreach.[3],[4]

What this means for you: You may feel more of a time crunch when it comes to choosing a health insurance plan, have fewer carrier options, and experience more difficulty finding helpful information.[5]

What you can do: Start the process as soon as possible, and get the help of a local, licensed health insurance producer. These individuals can assist you in exploring your affordable coverage options including ACA plans and alternatives as well as supplemental products.

 

Don’t go it alone this open enrollment season!

Find local help with Agent Finder

 

2. No cost-sharing reductions could mean you find a “free” bronze plan.

The Trump administration announced in October 2017 an end to cost-sharing reductions (CSRs).[6] Many health insurers anticipated this and filed 2018 rates accordingly. The average premium increase for silver plans (34 percent) was much higher than for bronze (18 percent) or gold (4 percent) plans.[7]

What this means for you: Your premium tax credit—the income-based subsidy that lowers what you pay for health insurance each month—may go further in 2018.[8] Premium tax credits are based on the second-lowest-cost silver plan in your area, and because bronze plan rates increased less than silver you may find you could pay nothing or next to nothing for a bronze plan.[9]

Of course, “free” insurance sounds great until you need healthcare and possibly face up to $7,350 in out-of-pocket expenses as an individual or $14,700 for a family—the maximum annual cost-sharing limits set for 2018.[10]

What you can do: Funnel your monthly premium savings into supplemental coverage. Starting at $31 per month, the Metal Gap 2 plan available through HealtheDeals.com bundles benefits that can help when you experience a critical illness or unexpected injury:

  • Up to $6,250 in accident medical expense
  • $7,500 in critical illness

These lump-sum benefits are paid directly to you, and you may use them to help pay your major medical plan deductible, household expenses such as your mortgage and other bills, transportation costs and more.

 

Make your bronze plan feel like gold!

Learn more about supplemental plans

 

3. What the IRS considers to be affordable health insurance has changed for 2018.

In 2018, an ACA health insurance plan that costs more than 8.05 percent of your household income is considered unaffordable; in 2017, the threshold was 8.16 percent.[11]

What this means for you: More people can escape the individual shared responsibility payment in 2018—due to the increase in the cost of health insurance and the fact that the definition of "unaffordable" has dropped slightly for 2018.

For example, the lowest bronze plan rate for a 45-year-old in Des Moines, Iowa, is expected to be $600 per month in 2018. That means if his adjusted gross income is less than $87,000 per year and he does not get a subsidy, he is not subject to the shared responsibility payment.

What you can do: If you qualify for an affordability exemption, you may want to consider an ACA alternative such as the medical bundle available through HealtheDeals.com. The medical bundle pairs a hospital plan for low-cost, high-occurrence claims and a short-term medical plan for protection from larger healthcare expenses.

For the same 45-year-old man in Des Moines, the most popular medical bundle plan available through HealtheDeals.com (including dental) would cost less than $350 per month, a $3,000 annual premium savings.

 

Explore affordable alternatives!

Find out if a medical bundle is right for you

 

4. Rather than offer group plans, eligible employers can use health reimbursement accounts (HRAs) to fund individual major medical plans.

Despite any issues ACA plans present (e.g., lack of carrier options, increasing rates), employers with fewer than 50 full-time employees continue to take advantage of Title XVII, sec. 18001 of the 21st Century Cures Act, which allows them to use HRAs to fund their employees’ individual major medical insurance premiums.

What this means for you: If your employer goes this route, they[12]:

  • Can fund medical care expenses for their employees on a pre-tax basis, up to a maximum dollar amount of:
    • $4,950 per individual
    • $10,000 per family
  • Pay or reimburse employees through HRAs to fund individual major medical insurance premiums
  • Must give employees a written notice of at least 90 days before they become eligible
  • Must report contributions on employee W2s

As an employee, you may decide to purchase a health insurance plan with a low monthly premium. Typically, the lower the monthly premium, the higher the plan deductible you must meet before benefits take effect.

What you can do: Use the money you save on monthly premiums to purchase additional benefits that can help lower out-of-pocket (OOP) medical expenses. Such coverage may include supplemental, hospital, dental, Rx discount cards and telemedicine plans; please note that HRA funds may not be applied to these types of benefits.

 

Get ready for unexpected expenses!

Learn about options to help lower your medical expenses

 

5. The IRS will enforce the individual mandate and tax penalty.

For the 2018 tax filing season, the IRS will enforce the individual mandate (i.e., individual shared responsibility provision) as well as the related tax penalty (i.e., individual shared responsibility payment) for those who fail to purchase coverage and are not exempt.[13] Tax returns will be rejected if they do not include requested information about the taxpayer’s health coverage.[14]

What this means for you: On your 2018 tax return, you will need to indicate whether or not you had health insurance. Unless you are exempt due to affordability or other circumstances, you could face a tax penalty if do not have health insurance that qualifies as minimum essential coverage.

What you can do: Get informed of all your coverage options—both on and away from the state-based and federally facilitated exchanges, and don't delay obtaining coverage.

What type of major medical plan will accommodate your budget and healthcare needs?

Which additional coverage options will help lower your family’s out-of-pocket expenses?

And, if you qualify for an exemption, how do you plan to pay for unexpected healthcare?

 

We’re here to help!

Search HealtheDeals.com on your own

Call the number at the top of your screen to speak with a producer

Find local help with Agent Finder

 

 


Legal Disclaimers

[1] There are some exceptions; some state-based exchanges have extended their enrollment deadlines beyond what has been set for HealthCAre.gov. Check with your exchange.

[2] HealthCare.gov. “Open Enrollment Period.” Accessed October 27, 2017. https://www.healthcare.gov/glossary/open-enrollment-period/

[3] Centers for Medicare & Medicaid Services. The Center for Consumer Information & Insurance Oversight. “2018 Projected Health Insurance Exchange Coverage Map: Final Insurer Participation in Health Insurance Exchanges.” Oct. 20, 2017. https://www.cms.gov/CCIIO/Programs-and-Initiatives/Health-Insurance-Marketplaces/2018-Projected-Health-Insurance-Exchange-Coverage-Maps.html

[4] Andrews, Michelle. “Limited Outreach, Shorter Sign-Up Time May Cause Insurance Headache in 2018.” NPR. Oct. 24, 2017. http://www.npr.org/sections/health-shots/2017/10/24/559565543/limited-outreach-shorter-sign-up-time-may-cause-insurance-headaches-in-2018

[5] Ibid.

[6] Kurtzleben, Danielle. “Trump Administration to End Obamacare Subsidies for the Poor.” NPR. Oct. 12, 2017. http://www.npr.org/2017/10/12/540920671/trump-administration-to-end-obamacare-subsidies-for-the-poor

[7] Mangan, Dan. “Most Popular Obamacare Plans Cost Average of 34 Percent More for 2018.” CNBC. Oct. 25, 2017. https://www.cnbc.com/2017/10/25/most-popular-obamacare-plans-cost-average-of-34-percent-more-for-2018.html

[8] Andrews, Michelle. “Limited Outreach, Shorter Sign-Up Time May Cause Insurance Headache in 2018.” NPR. Oct. 24, 2017. http://www.npr.org/sections/health-shots/2017/10/24/559565543/limited-outreach-shorter-sign-up-time-may-cause-insurance-headaches-in-2018

[9] Ibid.

[10] Thomson Reuters. “EBIA Weekly Newsletter: HHS Releases Final Notice of Benefit and Payment Parameters for 2018.” Jan. 5, 2017. https://tax.thomsonreuters.com/checkpoint-ebia-newsletter/hhs-releases-final-notice-of-benefit-and-payment-parameters-for-2018/

[11] EBIA Weekly Newsletter. “IRS Announces ACA Indexing Adjustments for Affordability and Premium Tax Credit Determinations for 2018.” Thomson Reuters. May 11, 2017. https://tax.thomsonreuters.com/checkpoint-ebia-newsletter/irs-announces-aca-indexing-adjustments-for-affordability-and-premium-tax-credit-determinations-for-2018/

[12] Congress.gov. “H.R. 34 – 21st Century Cures Act.” Accessed July 23, 2017. https://www.congress.gov/bill/114th-congress/house-bill/34/text#toc-HCFF0FABB859444AB8ED71110DD799717

[13] Internal Revenue Service. “ACA Information Center for Tax Professionals.” Last reviewed or updated Oct. 17, 2017. https://www.irs.gov/tax-professionals/aca-information-center-for-tax-professionals

[14] Ibid.