December 15 is the deadline for health insurance plans starting in January 2015

Health Insurance Coverage

The deadline for enrolling in health care coverage for 2015 is December 15. This date is important for not only new applicants, but also those who are renewing health insurance coverage for 2015.

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For those who purchased individual coverage in 2014, you will want to follow the “Five steps to staying covered through the Marketplace” which can be accessed at CMS. Coverage is also available through the Marketplace for the owners of small employer group health plans, comprised of 50 or fewer employees. Once a small employer selects one or more health plans for its employees, the employees themselves may enroll in the selected health plans through Healthcare.gov.

Most people must have coverage or pay a penalty. You may already be covered through your employer based plan, Medicare, Medicaid, CHIP, or other government sponsored plan, or you may be exempt from the coverage requirement. For 2015, the financial penalty for failure to enroll in a qualified health plan is the higher of either 2 percent of your income or $325 per adult and $162.50 per child under the age of 18 (for a total penalty of $975 per family when calculating individual penalties). Each state offers several health plans that provide coverage at different price points corresponding to the enrollee’s cost sharing responsibilities for the health services incurred during each annual coverage period.

So, what do you need to do to make sure that you and your family are covered beginning January 1, 2015?

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Individual coverage is available through the Health Insurance Marketplace, also known as insurance exchanges, sponsored by the federal and state governments. In the online Marketplace, you can shop and apply for coverage. You can preview the health plans and their prices before you apply by logging onto the Health Insurance Marketplace website at www.healthcare.gov/see-plans/. Upon application, you will be notified whether you qualify for an insurance plan, a premium tax credit to lower your monthly premium cost, and/or financial assistance with the health plan’s cost sharing features like co-payments and deductibles. The Marketplace will guide you through the process of estimating your 2015 income to determine your eligibility for cost savings. If you do not want to shop and apply through the website, you may call the Marketplace call center which is open 24 hours a day, seven days a week, 1-800-318-2596; TTY: 1-855-889-4325. Or, you can reach out to someone in your community to help you through the application and enrollment process by searching for the best person on HealthCare.gov.

Next, you will need to assure that you have the documents needed to apply, or renew your coverage through the Marketplace. You will be asked to provide information about yourself, your household, (for everyone applying you will need social security numbers, home addresses, if a legal immigrant, appropriate documentation of immigration status, employer and income information such as W-2 forms, any health insurance coverage currently in effect including policy numbers) and your best estimate of household income for 2015. You will need to complete an Employer Coverage Tool form for any and every person in your household who is eligible for job based coverage. The Marketplace is easy to navigate and provides a lot of useful tips to help you through the process.

Time to get started.

Lisa DeMoss is an Associate Professor at Western Michigan University Cooley Law School

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