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Navigating Changes During This Year’s Open Enrollment

posted by Jeanette Thornton

on October 17, 2016

The next Open Enrollment period for Marketplaces across the country begins in a few short weeks – on November 1, 2016.  From then through January 31, 2017, consumers can visit HealthCare.gov to enroll in new coverage or review their options.  While many of the features and processes for enrolling in Exchange coverage remain the same, there are some key changes for the upcoming year.  Here’s what’s new.

Selected Alternative Enrollments

If a current health plan is no longer available in 2017, the Marketplace will use a new process to match consumers to a similar health plan if they do not choose a new policy themselves by December 15. This differs from past years where consumers had to return to HealthCare.gov to proactively select their plan if their current insurer no longer offer coverage through the Marketplace.

There are some key dates to keep in mind for consumers who will have a new plan:

  • October – Health insurance companies will send a notice letting consumers know if their current coverage will not be available in 2017.
  • Before November 1 – The Marketplace will send an Open Enrollment notice informing consumers about being matched to a similar, alternate plan.
  • Mid-November – The Marketplace notice will identify the name of the specific plan consumers have been matched to.
  • Late November/Early December – Health plans will share information with those consumers about new coverage and how to pay the January premium.
  • December 15 – The deadline to return to HealthCare.gov to enroll in coverage for January 1. Consumers can choose a different plan if they do not want to keep the selected alternative and if another plan is available.  If consumers choose a different plan after this date, coverage will begin on February 1.
  • Remember: Consumers must pay the January premium by the health plan’s deadline to have coverage on January 1.

Extra Savings Label

Some consumers qualify for additional savings through reduced costs like copayments and deductibles if they enroll in a Silver plan. HealthCare.gov will use new labels and call-outs to help consumers review these types of plans.

  • Some plans will be labeled “Extra Savings” if consumers are eligible for reduced costs.
  • Reminders about your opportunity for extra savings before enrolling.
  • Remember: The monthly premium is only one factor in the overall cost of coverage. Consumers should consider the deductible and copays and review Silver plans if they are eligible for extra savings.

Quality Star Rating

The Marketplace is using a new star rating system to display information about some aspects of health plan quality.

  • Health plans in Virginia and Wisconsin will have new star ratings for three categories: Member Experience, Treatment & Prevention, and Plan Administration.
  • Remember: All plans offered on the Marketplace undergo rigorous reviews to ensure they provide quality coverage. These ratings are based on limited information and do not provide a complete picture of the quality of Marketplace health plans.

Network Size Label

The Marketplace is using new labels to compare the size of provider networks. These labels won’t include information about the quality of the network or access to doctors – they are based solely on the number of providers in the network.

  • Health plans in Maine, Ohio, Tennessee, and Texas will have new network size labels for three types of providers: primary care doctors, pediatricians, and hospitals.
  • Labels will indicate if the plan has a smaller, larger, or about the same size network in each category compared to other plans in the area.
  • Remember: Consumers should make sure their doctors and hospitals are included in a plan’s provider network before enrolling by using the HealthCare.gov provider search tool.

Jeanette Thornton is SVP of Health Plan Operations & Strategy at AHIP.