FOR IMMEDIATE RELEASE
October 30, 2015

Five Things to Know about Health Insurance Open Enrollment Period

Insurance Commissioner Jim Donelon is advising Louisiana families that the Open Enrollment period for health insurance coverage is November 1, 2015 through January 31, 2016. During the enrollment period individuals and families that do not receive healthcare through their employers can sign up through the online Health Insurance Marketplace or purchase individual policies sold by agents and insurers.

“It is especially important that folks stay vigilant during the Open Enrollment period as the January 31, 2016 deadline is earlier than last year’s cutoff,” said Commissioner Donelon. “Now is the time to review your current coverage and check out your options. A licensed health insurance agent can help you explore your choices and also help you determine if you’re eligible to receive financial assistance paying your premium.”

The Louisiana Department of Insurance (LDI) has launched a webpage ldi.la.gov/5things with the following key information regarding Open Enrollment:

  1. You must select coverage by December 15 to have coverage on January 1. The Open Enrollment period for coverage in 2016 is November 1, 2015 through January 31, 2016. This year’s deadline is 15 days earlier than last year’s deadline. If you need health insurance coverage to start on January 1, 2016, you must elect coverage by December 15, 2015. If you do not elect coverage by January 31, you will be unable to get healthcare coverage unless you qualify for a Special Enrollment Period due to a life change such as marriage, having a baby or losing other coverage. 
  2. You may be eligible for a subsidy to help with your premium. Tax credits are available to consumers who meet certain income thresholds to assist in paying monthly premiums. According to the U.S. Health and Human Services Department, about 90 percent of people in Louisiana who purchased coverage through the Health Insurance Marketplace in 2015 received subsidies. The subsidy is available for families with incomes between 100 percent and 400 percent of the poverty level who buy coverage through the Health Insurance Marketplace. To find out if you may be eligible for a subsidy or tax credit, visit healthcare.gov or contact an agent.   
  3. The penalty for not having coverage is increasing. The Affordable Care Act requires all Americans to have health insurance or face a tax penalty. The penalty is increasing this year to 2.5 percent of yearly household income or $695 for each person in your household who is not covered, whichever is higher. If you did not have coverage in 2015, you’ll pay the higher of $325 per person without coverage in the household or 2 percent of your yearly household income. All penalties are payable on the federal income tax return you file for the year you don’t have coverage.  
  4. Your 2015 plan may no longer be available in 2016. Plans can change from year to year and some plans that were available on the 2015 Marketplace may no longer be available. You also may be able to lower your out-of-pocket costs by switching plans. The Louisiana Health Cooperative (CO-OP) will no longer offer coverage in 2016. If you are a CO-OP customer, as long as you continue paying your premiums, you will have coverage until the end of the year. In order to have coverage past December 31, 2015, you will need to elect a new plan. See our frequently asked questions for more information on the CO-OP.  
  5. Going to out-of-network providers can be expensive. Make sure to review the doctors and other medical providers in a plan’s network. When you go out-of-network, you could face a higher coinsurance percentage.  

The Health Insurance Marketplace, established by the Affordable Care Act, allows consumers to compare health insurance plans based on key factors including providers, services and price. All plans that are part of the Marketplace must contain the same set of essential health benefits, including emergency services, hospitalization, prescription drugs and preventative and wellness services among others.

“Vigilance is also necessary because enrollment periods can bring scammers out of the woodwork. Folks need to be aware that these scams can take many forms, from the theft of private information such as social security numbers to the sale of fraudulent policies by people claiming to be agents” added Donelon. The Louisiana Department of Insurance maintains a searchable database of licensed insurance agents or you can call us at 1-800-259-5300.

Additional resources on the Louisiana Department of Insurance website include:

About the Louisiana Department of Insurance: The Louisiana Department of Insurance works to improve competition in the state’s insurance market while assisting individuals and businesses with the information and resources they need to be informed consumers of insurance. As a regulator, the LDI enforces the laws that provide a fair and stable marketplace and makes certain that insurers comply with the laws in place to protect policyholders. You can contact the LDI by calling 1-800-259-5300 or visiting www.ldi.la.gov.