If you are planning to secure insurance coverage for yourself or your employees through the new health care marketplace, the deadline to do so is fast approaching: March 31 is the final day of open enrollment for coverage in 2014.
HealthCare.gov was established last fall under the Affordable Care Act, which was signed into federal law in 2010 and is being implemented in phases. A portion of the law called the “individual mandate” requires all Americans to have health care coverage by the open enrollment deadline or pay the cost of their health care treatment plus face a penalty of 1 percent of their yearly income or $95 a person, whichever is higher. The amount of the penalty is scheduled to rise in subsequent years. The mandate may be waived because of financial hardship or religious beliefs by completing an exemption application online.
How the Marketplace Works
The marketplace, which comprises federal and state insurance exchanges, gives individuals a place to compare, purchase, or change coverage online. Participating providers may not deny applicants coverage even if an individual has a pre-existing health issue.
The marketplace is generally available only during open-enrollment periods. The period for 2014 ends March 31. The open-enrollment period for 2015 is scheduled to begin on Nov. 15. (Exceptions include qualifying life changes, such as marriage, divorce, or childbirth that allow immediate access to coverage.)
The online marketplace, which launched on Oct. 1, was plagued by computer problems at its onset. The U.S. Department of Health and Human Services reports on its website that (Note: new number according to website) 6 million people have since secured insurance coverage through the marketplace (and its call center). Because of the history of technical problems and the potential for high volume near the deadline, Health and Human Services officials say applicants who begin an application before March 31 and don’t make the deadline because of special circumstances or complicated cases, will have the opportunity to ask for a grace period on the application.
What the Law Does (and Doesn’t) Require
Although the law says you must be covered, it doesn’t say that you must obtain coverage through the online marketplace. Individuals may still shop for health insurance the traditional way, through providers or brokers.
The Affordable Care Act does not require small-business owners with fewer than 50 full-time employees to provide health insurance to their employees. If you choose to do so,
you may use the SHOP Marketplace [PDF], which is designed to assist entrepreneurs in securing coverage for their workforces. Sole proprietors may also shop for policies for themselves and their families on the exchanges.