State Schedules Information Sessions about Open Enrollment and New Procedures 

Federal officials have put in place a new option for the continuation of Marketplace insurance coverage under certain conditions. It’s a backup option for people whose current insurers are dropping out of the Marketplace, if those individuals fail to choose a plan on their own by the end of the upcoming open enrollment period.

Creating options for those individuals is an important issue this year because a number of insurers have announced that they are no longer participating in the federal Marketplace. The Office of the Commissioner of Insurance (OCI) estimates that about 37,000 Wisconsinites participating in the Marketplace this year will have to switch to a different insurer in 2017.

I commend federal officials for creating a fallback option for people who may need to use it, but I hope it is rarely needed.  There is broad agreement among insurers, providers and advocates that it is far better for people to carefully review their options and then choose which insurance plan is best for them.

For the most part, the process of enrolling in insurance plans through the federal Marketplace will be the same this year as last year:

• The open enrollment period will run from November 1 to January 31.
• As a general rule, people need to apply for coverage and select a plan by December 15 in order to have insurance coverage in January.
• Like last year, someone who is in a Marketplace plan and does not renew it or select a new plan by December 15 will beautomatically re-enrolled in the same plan, but they still have until January 31 to select a different plan.

The new wrinkle in enrollment procedures applies just to people whose current insurer is dropping its Marketplace plans:

• If those individuals do not reapply for coverage and select a new plan by December 15, they will be automatically assigned to a similar plan.
• This process provides an option for people who don’t take action by December 15 to continue to have coverage in January. (Alternatively, they can select a new plan with coverage effective January 1 by attesting to the loss of minimum essential coverage through HealthCare.gov and choosing a new plan by December 31.)
• They are not required to purchase coverage, and they still have until January 31 to select a different plan.

The new process is generally referred to as auto-enrollment, but that’s a bit misleading and reinforces the misconception that it may force people to participate in a plan that they didn’t choose. As this blog post by Judy Solomon of the Center on Budget and Policy Priorities explains, the new option doesn’t force anyone to do anything; it merely provides a “backstop” for people who fail to choose their own plan.

OCI is holding a series of information sessions across the state to educate people about enrollment options, including the drawbacks of relying on auto-enrollment. Although I have disagreed at times with some of the tone and substance of OCI comments about the new policy, I’m glad they are holding these meetings and helping people understand the consequences of the choices they make or fail to make.

There are many reasons why everyone participating in the federal Marketplace should go online (HealthCare.gov) and choose a new plan:

• To make any changes related to their income and household.
• To check the plans that are currently available, their costs, and how federal subsidies will affect the net premiums.
• To check on which providers are in each plan’s network, in order to determine which plan best meets their needs.

People who are considering their insurance options are encouraged to seek assistance from “navigators,” certified application counselors and insurance agents/brokers who can help them work through their choices for 2017. A list of free local assistance in each county can be found on this Covering Wisconsin webpage.

A list of all the upcoming OCI meetings can be found here.  More information about open enrollment and the “auto re-enrollment” process can be found on this HHS webpage.

Jon Peacock