February 10 – February 16, 2015

Open Enrollment for 2015 Marketplace Coverage Closes; Marketplaces Accommodating Consumers Unable to Complete Application by Deadline: February 15 was the last day of the second open enrollment period for the health insurance marketplaces. In the days before the deadline, the federally facilitated marketplace (FFM) faced high call center volume and a temporary systems issue that prevented some consumers from completing their applications before February 15. FFM applicants who were unable to enroll due to these issues can get a time-limited Special Enrollment Period (SEP) through February 22. These consumers can complete their applications online at HealthCare.gov or through the call center (800-318-2596). Many state-based marketplaces (SBMs) also instituted policies to accommodate consumers that were unable to complete the enrollment process by February 15. For more on specific SBM policies, see our blog post on the topic.

Individuals who experience a qualifying life event during 2015, such as losing coverage or getting married, may be able to qualify for new coverage through an SEP, and eligible individuals can enroll in Medicaid and the Children’s Health Insurance Program year-round. Otherwise, open enrollment for 2016 marketplace coverage is expected to begin October 1 and run through December 15, 2015.

Tax Filing Season Considerations for Marketplace Enrollees:  Consumers who were enrolled in marketplace coverage in 2014 will need to use the new Form 1095-A to file their federal taxes this year. This form includes information about the months the individual was enrolled in marketplace coverage and the amount of premium tax credits received. The FFM mailed all of the forms by February 2, but any consumer who has not received their form in the mail — and who cannot find their form in their online account — should contact the marketplace call center at 800-318-2596. Also, CMS updated its Frequently Asked Questions document for assisters helping consumers use the Form 1095-A on February 9. SBMs have been mailing the forms on varying schedules, and consumers with questions should contact their state’s marketplace.

Tips From CMS for Assisters on Working with Agents and Brokers: On February 10, the Centers for Medicare and Medicaid Services (CMS) posted a new tip sheet to help assisters who are partnering with agents and brokers, which includes information on consumer referrals and the differences between agents and brokers.

CMS Delays Cost-Sharing Reduction Reconciliation With Insurers: On February 13, CMS issued guidance updating the reconciliation process for cost-sharing reduction payments between the marketplace and insurers. Cost-sharing reductions are available to consumers who are enrolled in Silver plans and have incomes up to 250 percent of the federal poverty level. Citing the need for improved accuracy and additional time for issuers to adopt the new payment methodology, CMS will delay reconciliation for the 2014 plan year for one year until April 30, 2016.

Enrollment Updates 

NoteCollecting and reporting of enrollment numbers varies by marketplace. To fully understand the enrollment numbers below, it may be necessary to view the original source for context (source links are provided).

  • Nationwide: A total of 11.4 million Americans had selected a new marketplace plan or were automatically renewed for 2015 as of February 15.
  • FFM: A total of 8.6 million Americans had selected a new marketplace plan or were automatically renewed through HealthCare.gov as of February 15.
  • SBMs: A total of 2.8 million marketplace plan selections (new and renewing consumers) as of February 15.
  • District of Columbia: A total of 20,358 marketplace plan selections and 44,457 enrolled in Medicaid/CHIP since the start of OE1 as of February 8.
  • Maryland: A total of 113,463 marketplace plan selections (new and renewing consumers) and 139,769 enrolled in Medicaid/CHIP since the start of OE2 as of February 15.
  • Massachusetts: A total of 95,921 marketplace plan selections (new and renewing consumers) and 237,741 enrolled in Medicaid/CHIP during OE2 as of February 10.
  • Minnesota: 49,238 marketplace plan selections and 90,995 enrolled in Medicaid/CHIP as of February 13.
  • Rhode Island: A total of 28,787 marketplace plan selections (new and renewing consumers) as of February 7.
  • Washington State: A total of nearly 160,000 marketplace plan selections (new and renewing consumers) as of February 15.
  • Vermont: A total of 33,042 marketplace plan selections (new and renewing consumers) for 2015 as of February 9.
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