Open Enrollment Begins November 1st


2019 Open Enrollment begins November 1 and runs through December 15

If you're buying health insurance on your own, you can purchase a policy:

  • From a health insurance agent

  • From websites that offer health insurance quotes from multiple carriers

  • Directly from a health insurance company

  • From your state’s health insurance marketplace - Healthcare.gov

Beginning November 1, you can apply:

  • Online

  • By phone

  • With in-person help

  • Through an agent or broker

  • With a paper application

WHAT YOU NEED TO KNOW

~ Tax penalties will no longer be assessed to those without coverage ~

The ACA required nearly all Americans to have health insurance. However, Congress decided in 2017 to eliminate the individual mandate penalty.

So, though the individual mandate is technically still on the books, the penalty is not. You won't get whacked at tax time if you don't have health insurance.

~ Open enrollment is is the time to make changes to your current plan ~

During open enrollment, you can:

  • Renew your current individual/family health insurance plan.

  • Choose a new health insurance plan through the marketplace in your state or through private insurance.

If you are currently enrolled in a marketplace health insurance plan, it will automatically renew. However, the plan may make changes to its provider network, copay's, co-insurance and drug coverage. Your plan is required to send you a notice of any changes it will make for 2019.

~ You can choose among four levels of individual/family insurance plans ~

health insurance marketplace only

Plans in the health insurance marketplace are divided primarily into four categories:

  • Bronze - highest out-of-pocket expenses for services, lower premiums

  • Silver

  • Gold

  • Platinum - lowest out-of-pocket expenses for services, higher premiums

~ All health plans must cover 10 essential benefits ~

Regardless of plan level, or category, chosen, all policies must provide some level of coverage for the following benefits:

  • Outpatient care including chronic disease management

  • Emergency care

  • Hospitalization

  • Pregnancy and newborn care

  • Mental health and substance abuse services

  • Prescription drugs

  • Rehabilitation services and devices

  • Lab tests

  • Preventive and wellness services

  • Dental and vision care for children

~ Short-term plans are now available ~

The ACA limited short-term plans, also called catastrophic plans, to young people or those who couldn't afford any other coverage. However, the Trump administration has opened up short-term health plans to everyone.

Short-term plans have low premiums, so you pay little upfront, but if you need healthcare services, a short-term plan might provide little coverage and is exempt from covering the 10 essential health benefits.

~ Your family size and income determines your eligibility for tax credits ~

health insurance marketplace only

You may qualify for a premium tax credit which is based on income and family size. To qualify, your family income must fall between 100 and 400 percent of the federal poverty level (FPL).

If you qualify, the credits can be applied to your monthly insurance premiums. If your income changes during the year and you no longer qualify for the credits when you file your taxes, you will have to repay the credits received.

If you don’t enroll by December 15, you can’t get 2019 coverage unless you qualify for a Special Enrollment Period

Special Enrollment Period (SEP)

You qualify for a Special Enrollment Period if you’ve had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child.

If you qualify for an SEP, you usually have up to 60 days following the event to enroll in a plan. If you miss that window, you have to wait until the next Open Enrollment Period to apply.

You can enroll in Medicaid and the Children’s Health Insurance Plan (CHIP) any time of year, whether you qualify for a Special Enrollment Period or not.

Job-based plans must provide a special enrollment period of at least 30 days.

If you have an ACA-compliant plan that you purchased outside the exchange, it may be worth checking again during open enrollment to see whether you’d be better off with a plan through the exchange for 2019, or with a different off-exchange plan.

For questions regarding the Marketplace insurance, call 1-800-318-2596.

While we are, of course, available to provide you with any business, accounting or tax services, the information contained herein is general in nature; any advice regarding those services should not be construed as tax advice and is not intended as a thorough, in-depth analysis of specific issues, a substitute for a legal, accounting or tax advice or opinion, nor is it sufficient to avoid tax-related penalties to the reader. The reader also is cautioned that this material may not be applicable to, or suitable for, the reader's specific circumstances or needs, and may require consideration of non-tax and other tax factors if any action is to be contemplated. The reader should contact Strive Tax & Accounting, LLC or other tax professional prior to taking any action based upon this information. Strive Tax & Accounting, LLC assumes no obligation to inform the reader of any changes in tax laws or other factors that could affect the information contained herein.

#ACA #Wisconsin #individualtax #healthinsurance

 Our primary goal as a trusted advisor is to be available and to provide insightful advice to enable our clients to make informed financial decisions.

Continually striving for accuracy, excellence and the highest level of integrity.

Strive Tax & Accounting, LLC

CPA's specializing in small business tax and accounting with emphasis in construction and manufacturing for corporation and passthrough entities.

PO Box 28353

Green Bay, WI 54324

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