California and Washington Continue with Record Enrollments

Insurance marketplaces in states like California and Washington have been making headlines recently as they continue to outperform the federal marketplace in coverage provided by portals such as healthcare.gov. These performances have shown that states are effectively reaching and exceeding federal standards more successfully than federal programs.

California and Washington specifically have provided policies for approximately 50 percent of the amount of people who have been covered by the federal marketplace which services most of the nation. These signups apply for the Special Enrollment Period (SEP) which began when the Open Enrollment Period (OEP) closed in February 2015.

Healthcare Marketplaces

Under the Affordable Care Act, also known as the ACA or “Obamacare,” all citizens must have access to public healthcare options and must be insured by a certain deadline or face a fine. People looking to purchase insurance that meets government standards for federal programs and benefits must purchase insurance through a designated marketplace.

One such marketplace is the healthcare.gov website, which has been criticized as being difficult to navigate and unintelligible. By introducing their own marketplaces and raising awareness through advertising, the states of California and Washington signed up record amounts of people during their Special Enrollment Periods.

Enrollment Periods

In order to ensure that all people are adequately covered, those seeking to purchase insurance from a marketplace must do so within a certain timeframe. This timeframe usually runs from the end of the year to the first few months of the new year and counts for that new year. There are two distinct types of enrollment periods. They are known as an Open Enrollment Period (OEP) and a Special Enrollment Period (SEP).

Open Enrollment Period

The OEP is a window in which people looking to purchase insurance from federally-approved marketplaces may purchase their coverage without incurring a fee. The OEP typically lasts from November to February, which is when it ended in 2015. However, since the laws have only recently taken effect and this is a new system, there is a grace period after the OEP has closed in which people are allowed to purchase coverage from a marketplace.

Special Enrollment Period

The SEP is a window in which people looking to purchase insurance from federally-approved marketplaces may purchase their coverage if they have missed the OEP. In some cases, a fee may still apply. Recently, the fee has been waived or is based upon an honor system. It is likely that SEPs will be less forgiving in the future but these new proceedings are still in their infancy. The SEP for 2015 ends in April. In cases that involve a change in life circumstances such as marriage or pregnancy, SEPs are typically offered with no fee.