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Insurance Talk — COVID Special Enrollment for Health Insurance

Insurance Talk — COVID Special Enrollment for Health Insurance

Rex and Cheri have the answers. Listen here.


Cheri Martinen – Welcome to Insurance Talk with Cheri Martinen and my special guest today, Valerie Best, from our downtown La Pine office. Welcome Valerie. Valerie Best – Thank you so much, Cheri. It’s a pleasure to be here.

COVID Health Insurance Special Enrollment Period

CM – Today, we are talking about something that we don’t normally see, which is the COVID special enrollment for health insurance that’s happening right now in Oregon. It started February 15th and it goes through May 15th. This is a once in a lifetime special enrollment, I don’t think we’re going to see this again.

As some people know, or may have seen in the news, President Biden put in a special enrollment period for health insurance specifically for COVID, saying that not everyone was able to get in to see their health insurance marketplace or to see one of their professionals like Valerie, myself, Jennifer, or Patty at our office. They needed extra time. This special enrollment period is longer than our original enrollment period.

VB – Yes, by six weeks.

CM – So we’re getting twice as much time. We’re getting a lot of questions about it and we just wanted to talk about what’s going on, who can enroll, who can’t enroll, what can you do, what can’t you do, and how that affects you out there in the world.

Who Can Enroll? What Can You Do?

VB – As Cheri stated, we have a special enrollment period. This is for individual and family health insurance. You don’t currently have to be on a marketplace or exchange, or currently have to have individual health insurance. This special enrollment period will allow you to enroll if you missed it last year. So can a current individual and a family member change coverage? Yes. If you’ve found yourself enrolled in a plan, or maybe you got renewed without your knowledge, you have the opportunity to change to another plan. You can change carriers and you can change what plan you’re on.

CM – I think this comes into play, this is kind of what I’m thinking, if maybe last year you knew your doctor was in network and everything’s going fine. This year you make your annual appointment and it turns out your doctor is no longer in network with that carrier. Maybe you want to take this opportunity with this special enrollment to enroll in a plan where your doctor is in-network.

VB – Exactly. Another example might be if they renewed your policy based on last year’s income, and you need to update that. All of a sudden you find yourself on a gold plan and your income has changed, and you need to be on a bronze plan or a silver level plan.

Update Income, Change Subsidy Amount

CM – And the reason she talked about the income was the subsidy. If your income changes, that’s going to change the amount of subsidy you receive. If you had a lower income, you might’ve been able to afford a higher level plan, especially a silver or gold because you get more assistance from the government. And then if your income changes and you’re making more money, you get less assistance so you’re going to be seeing a higher bill. Right now is actually a good time to look at that and say, was I prepared for that January 1st or February 1st bill with my health insurance? Do I need to adjust that?

VB – And what’s going to happen for the rest of the year? That’s a very good point, being able to adjust your income. What I will tell you is that even if you have chosen not to enroll with Bancorp Insurance through the federally facilitated marketplace, if you’ve gone direct and you just want to go in and review and maybe change your plan on your own, the only requirement is that you step through the entire application.

You log into your account on the left-hand side, you select ‘Report a Life Change’ and then ‘Change in My Income’ or ‘Change in My Family Size’. What you have to do is step through the entire application, view your eligibility, and then you’ll be allowed to change to whatever plan you choose.

No Subsidy? No Problem

The other thing I was going to say is that even if you are not receiving a federal subsidy, you can still go through this special enrollment period and make any changes that you choose to your current plan. But you just have to step through that application. There will be no special enrollment questions or qualifiers. You don’t have to provide any qualifying event like the birth of a child or a death. There will be no data matching questions, like you don’t have to verify income, you don’t have to prove citizenship. There are going to be no data matching issues. Pretty much anybody who is eligible to enroll in a marketplace plan is eligible for this change.

Again, even if you phase-out income wise, you are still eligible to change your plan at this time. When we talk about marketplace eligible consumers, we’re talking about people living in the US for tax purposes, US citizens or nationals, and someone who’s not incarcerated because of course they already have health care. But again, there are no qualifying questions. There are no new questions on the application. You simply have to step through it, view your eligibility, and then you can change plans. And of course, Bancorp Insurance would love to do that for you.

Once in a Lifetime Opportunity

CM – Like I said at the beginning of this, this is really a once in a lifetime opportunity. I don’t imagine them doing this type of special enrollment period ever again. Normally for this time of year, if you came to us and said, ‘This health insurance isn’t working for me, I need to change my plan.’ We’d tell you, ‘Sorry, you’re out of luck.’ So this is a once in a lifetime opportunity to adjust your health insurance midway through the year. It goes all the way until May 15th, which is, again, a huge amount of time, more than you get in December. Normally it’s just November 1st to December 15th, it’s about 45 days.

VB – Exactly. The other thing that they’re providing with this special enrollment period is an accelerated effective date. Normally, when there’s a special enrollment period, if you change plans after the 16th of the month, they roll your effective date out to the first of the following month. But this time they’re going to give accelerated effective dates. So even if you enroll on the 15th, the 20th, the 27th, you will have an effective date of the first of the following month. So they are giving us those accelerated effective dates as well.

CM – You can actually get coverage faster at this point with this particular special enrollment period that you would not be able to get otherwise.

VB – We’re seeing a lot of positive responses from the clients that we do have and encourage anybody and everybody to look at this. As Cheri said, it’s a good time to review your options because you don’t have to stay where you are.

CM – So if you already reviewed back in November or December and you’re feeling good, that’s great. If you missed it, it always seems like in January and February, we get those phone calls and they’re like, ‘Hey, I got my bill and I should have talked to you.’ Then we have to say it’s too late. This year it’s not. This year, you really can adjust it and make changes. We are here to help you.

We’ve got Valerie Best, Jennifer Ward, and Patty Starkey, all waiting to help anyone who calls. And we are back in the office, so if you needed to sit down one-on-one with someone they’d be happy to do that as well with a mask on and a shield and all the other good things that come with COVID. Again, this is the COVID special enrollment period. Is there any other fun stuff with this one that we need to mention?

VB – I just want to remind people that you don’t have to have any documentation of a qualifying event, no new application questions.

CM – They made it really easy. They want as many people to enroll as possible. This is almost easier than during the original open enrollment.

VB – Cheri and I were talking about that and it’s like we’ll take anybody now. There were so many disqualifiers and right now they just want to make sure everybody has individual health insurance and that everybody is safe during this tumultuous time.

Enroll Now Through May 15!

CM – And you can get this health insurance if you have recently lost health insurance from an employer. You can get this health insurance if you have recently changed your address or moved. You don’t have to wait for another period of time or anything like that. You can do it right now.

VB – If you are someone who chooses to go direct with companies here in the state of Oregon, they have mandated now that individuals that are not enrolled through the federally facilitated marketplace will be eligible for the same special enrollment qualifiers or benefits that the people in the FFM are entitled to. So anybody can change plans right now, review their coverage, make a step in another direction that might be more effective for you and your family, and get you covered maybe where you didn’t have an opportunity last year.

CM – We’re here at Bancorp Insurance, 1-800-452-6826. You can visit us online at www.bancorpinsurance.com. You’re listening to us on our podcast here. If you like what you hear, you can listen to more information about health insurance, Medicare, as well as commercial lines and personal lines insurance services. We do so much. Special enrollments for individuals 18 years of age up to 65. Like we said, it’s such a big group of people. You have an opportunity that is not going to come around again.

VB – Exactly. And if you’re not sure you qualify, even if we process you in enrollment and it turns out you might be OHP eligible or have some other eligibility for healthcare besides that, they’re going to direct you to those resources to make sure you get the healthcare that you need.

CM – Contact Bancorp Insurance at 1-800-452-6826.

Rex and Cheri have the answers. Listen here.


Cheri Martinen – Welcome to Insurance Talk with Cheri Martinen and my special guest today, Valerie Best, from our downtown La Pine office. Welcome Valerie. Valerie Best – Thank you so much, Cheri. It’s a pleasure to be here.

COVID Health Insurance Special Enrollment Period

CM – Today, we are talking about something that we don’t normally see, which is the COVID special enrollment for health insurance that’s happening right now in Oregon. It started February 15th and it goes through May 15th. This is a once in a lifetime special enrollment, I don’t think we’re going to see this again.

As some people know, or may have seen in the news, President Biden put in a special enrollment period for health insurance specifically for COVID, saying that not everyone was able to get in to see their health insurance marketplace or to see one of their professionals like Valerie, myself, Jennifer, or Patty at our office. They needed extra time. This special enrollment period is longer than our original enrollment period.

VB – Yes, by six weeks.

CM – So we’re getting twice as much time. We’re getting a lot of questions about it and we just wanted to talk about what’s going on, who can enroll, who can’t enroll, what can you do, what can’t you do, and how that affects you out there in the world.

Who Can Enroll? What Can You Do?

VB – As Cheri stated, we have a special enrollment period. This is for individual and family health insurance. You don’t currently have to be on a marketplace or exchange, or currently have to have individual health insurance. This special enrollment period will allow you to enroll if you missed it last year. So can a current individual and a family member change coverage? Yes. If you’ve found yourself enrolled in a plan, or maybe you got renewed without your knowledge, you have the opportunity to change to another plan. You can change carriers and you can change what plan you’re on.

CM – I think this comes into play, this is kind of what I’m thinking, if maybe last year you knew your doctor was in network and everything’s going fine. This year you make your annual appointment and it turns out your doctor is no longer in network with that carrier. Maybe you want to take this opportunity with this special enrollment to enroll in a plan where your doctor is in-network.

VB – Exactly. Another example might be if they renewed your policy based on last year’s income, and you need to update that. All of a sudden you find yourself on a gold plan and your income has changed, and you need to be on a bronze plan or a silver level plan.

Update Income, Change Subsidy Amount

CM – And the reason she talked about the income was the subsidy. If your income changes, that’s going to change the amount of subsidy you receive. If you had a lower income, you might’ve been able to afford a higher level plan, especially a silver or gold because you get more assistance from the government. And then if your income changes and you’re making more money, you get less assistance so you’re going to be seeing a higher bill. Right now is actually a good time to look at that and say, was I prepared for that January 1st or February 1st bill with my health insurance? Do I need to adjust that?

VB – And what’s going to happen for the rest of the year? That’s a very good point, being able to adjust your income. What I will tell you is that even if you have chosen not to enroll with Bancorp Insurance through the federally facilitated marketplace, if you’ve gone direct and you just want to go in and review and maybe change your plan on your own, the only requirement is that you step through the entire application.

You log into your account on the left-hand side, you select ‘Report a Life Change’ and then ‘Change in My Income’ or ‘Change in My Family Size’. What you have to do is step through the entire application, view your eligibility, and then you’ll be allowed to change to whatever plan you choose.

No Subsidy? No Problem

The other thing I was going to say is that even if you are not receiving a federal subsidy, you can still go through this special enrollment period and make any changes that you choose to your current plan. But you just have to step through that application. There will be no special enrollment questions or qualifiers. You don’t have to provide any qualifying event like the birth of a child or a death. There will be no data matching questions, like you don’t have to verify income, you don’t have to prove citizenship. There are going to be no data matching issues. Pretty much anybody who is eligible to enroll in a marketplace plan is eligible for this change.

Again, even if you phase-out income wise, you are still eligible to change your plan at this time. When we talk about marketplace eligible consumers, we’re talking about people living in the US for tax purposes, US citizens or nationals, and someone who’s not incarcerated because of course they already have health care. But again, there are no qualifying questions. There are no new questions on the application. You simply have to step through it, view your eligibility, and then you can change plans. And of course, Bancorp Insurance would love to do that for you.

Once in a Lifetime Opportunity

CM – Like I said at the beginning of this, this is really a once in a lifetime opportunity. I don’t imagine them doing this type of special enrollment period ever again. Normally for this time of year, if you came to us and said, ‘This health insurance isn’t working for me, I need to change my plan.’ We’d tell you, ‘Sorry, you’re out of luck.’ So this is a once in a lifetime opportunity to adjust your health insurance midway through the year. It goes all the way until May 15th, which is, again, a huge amount of time, more than you get in December. Normally it’s just November 1st to December 15th, it’s about 45 days.

VB – Exactly. The other thing that they’re providing with this special enrollment period is an accelerated effective date. Normally, when there’s a special enrollment period, if you change plans after the 16th of the month, they roll your effective date out to the first of the following month. But this time they’re going to give accelerated effective dates. So even if you enroll on the 15th, the 20th, the 27th, you will have an effective date of the first of the following month. So they are giving us those accelerated effective dates as well.

CM – You can actually get coverage faster at this point with this particular special enrollment period that you would not be able to get otherwise.

VB – We’re seeing a lot of positive responses from the clients that we do have and encourage anybody and everybody to look at this. As Cheri said, it’s a good time to review your options because you don’t have to stay where you are.

CM – So if you already reviewed back in November or December and you’re feeling good, that’s great. If you missed it, it always seems like in January and February, we get those phone calls and they’re like, ‘Hey, I got my bill and I should have talked to you.’ Then we have to say it’s too late. This year it’s not. This year, you really can adjust it and make changes. We are here to help you.

We’ve got Valerie Best, Jennifer Ward, and Patty Starkey, all waiting to help anyone who calls. And we are back in the office, so if you needed to sit down one-on-one with someone they’d be happy to do that as well with a mask on and a shield and all the other good things that come with COVID. Again, this is the COVID special enrollment period. Is there any other fun stuff with this one that we need to mention?

VB – I just want to remind people that you don’t have to have any documentation of a qualifying event, no new application questions.

CM – They made it really easy. They want as many people to enroll as possible. This is almost easier than during the original open enrollment.

VB – Cheri and I were talking about that and it’s like we’ll take anybody now. There were so many disqualifiers and right now they just want to make sure everybody has individual health insurance and that everybody is safe during this tumultuous time.

Enroll Now Through May 15!

CM – And you can get this health insurance if you have recently lost health insurance from an employer. You can get this health insurance if you have recently changed your address or moved. You don’t have to wait for another period of time or anything like that. You can do it right now.

VB – If you are someone who chooses to go direct with companies here in the state of Oregon, they have mandated now that individuals that are not enrolled through the federally facilitated marketplace will be eligible for the same special enrollment qualifiers or benefits that the people in the FFM are entitled to. So anybody can change plans right now, review their coverage, make a step in another direction that might be more effective for you and your family, and get you covered maybe where you didn’t have an opportunity last year.

CM – We’re here at Bancorp Insurance, 1-800-452-6826. You can visit us online at www.bancorpinsurance.com. You’re listening to us on our podcast here. If you like what you hear, you can listen to more information about health insurance, Medicare, as well as commercial lines and personal lines insurance services. We do so much. Special enrollments for individuals 18 years of age up to 65. Like we said, it’s such a big group of people. You have an opportunity that is not going to come around again.

VB – Exactly. And if you’re not sure you qualify, even if we process you in enrollment and it turns out you might be OHP eligible or have some other eligibility for healthcare besides that, they’re going to direct you to those resources to make sure you get the healthcare that you need.

CM – Contact Bancorp Insurance at 1-800-452-6826.

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