Department of Health and Human Service Releases Report on 2015 Open Enrollment

The U.S. Department of Health and Human Services (“HHS”) released a report on January 27, 2015 entitled “Health Insurance Marketplace 2015 Open Enrollment Period: January Enrollment Report” (“Report”). In the Report, HHS stated that approximately 9.5 million consumers either selected or were automatically re-enrolled in a health plan through a Health Insurance Marketplace (“Marketplace”) during the first two months of the 2015 open enrollment period. The period for open enrollment in the Marketplaces is from November 15, 2014 through February 15, 2015 (please note the recent update below).

Health Insurance Marketplaces

Marketplaces were formed as a result of the Patient Protection and Affordable Care Act, requiring states to create Marketplaces wherein individuals and small businesses are able compare options and purchase insurance. There are three types of Marketplaces including (1) those created by individual states, (2) those that are considered Federally Facilitated Marketplaces (“FFM”) and (3) those that are operated as a partnership between the Federal government and the state.

The Marketplaces were created to provide individuals and small businesses with a “one-stop shop” to purchase better quality insurance at lower costs through the use of a large pool of purchasers and increased competition with various available health insurance options. The Marketplaces offer different coverage options at the bronze, silver, gold and platinum levels, which are 60%, 70%, 80% and 90%; respectively, of the full amount of actuarial benefits provided under the plan.

The Report

As outlined above, the open enrollment period for the Marketplaces for the 2015 year commenced on November 15, 2014 and was set to close on February 15, 2015 (please note the recent update below). The Report provides information related to enrollment during the first two months of the open enrollment period and is divided into the following four sections:

  • Section I provides data with respect to the 37 states that are operating as FFMs;
  • Section II addresses the 14 states, including Washington, D.C., that are operating their own Marketplaces;
  • Section III provides a methodological overview of how the data was obtained and calculated; and
  • Section IV provides appendices, including characteristics and tables.

The Report’s appendices are (1) Characteristics of Marketplace Plan Selections, (2) Selected State-Level Tables for FFMs, (3) Selected State-Level Tables for states operating their own marketplaces, and (4) Technical Notes.

Key Findings

As outlined above, more than 9.5 million Americans had selected or had been automatically re-enrolled in a 2015 health insurance plan through a Marketplace.

Federally Facilitated Marketplaces

More than 7.1 million enrollees either selected or were automatically re-enrolled through a FFM. According to the Report, of the more than 7.1 million FFM enrollees:

  • 87% selected a plan with financial assistance;
  • 35% were under age 35; and
  • 58% re-enrolled in a Marketplace plan and 42% selected a plan for the first time.

State Operated Marketplaces

There are currently 14 states that are operating their own Marketplaces. The Report notes that the states of California and Florida have had the highest plan selections to date, 1.2 million and 1.3 million, respectively. Approximately 2.4 million enrollees did so through state operated Marketplaces.

Update

Outlined above are some of the more significant findings included in the Report. However, due to technical difficulties encountered by some registrants with the HealthCare.gov website experienced on Saturday, February 14th, the deadline of February 15th has been extended in some instances. As noted on the HealthCare.gov website, coverage may still be obtained for 2015 if:

  • Enrollment in health coverage was attempted on or before February 15th, but the application was not able to be completed due to an issue with HealthCare.gov or the Marketplace Call Center that caused a delay with the application.
  • A paper application for Marketplace coverage was mailed on or before February 15th and a notice was received indicating the ability to complete enrollment in Marketplace coverage.

As noted on the website, the extension of time to enroll will only be available for the abovementioned circumstances and only for a short period of time. If either of these situations has occurred, the application process should be completed online or by contacting the Marketplace Call Center as soon as possible to complete enrollment over the phone.

A copy of the Report may be accessed online.

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The information contained herein is not necessarily all inclusive, does not constitute legal or any other advice, and should not be relied upon without first consulting with appropriate qualified professionals for your individual facts and circumstances.

Health Insurance Marketplace 2015 Open Enrollment

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