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Enrollment 2018

For Marketplace Customers Who Delay, Auto-Enrollment Could Be Nasty Wake-Up

(Illustration created using Getty Images)

Shopping to update your coverage on the health insurance marketplace may be annoying — didn’t you just do this last year? But letting the exchange automatically renew your coverage instead could be a big mistake. If you don’t like the plan you’re auto-enrolled in this year you may be stuck with it in 2018, unlike previous years when people could generally switch.

It’s all in the timing. This year, the open enrollment period, which started Nov. 1, will end a week from today, on Dec. 15 in most states. On Dec. 16, if you haven’t picked a new plan, the marketplace will generally re-enroll you in the one you’re in this year or another one with similar coverage.

But unlike previous years when the open enrollment period ran through the end of January, this year open enrollment will generally be over by the time you see which plan you’ve been assigned to.

“The deadline catches up with people,” said Karen Pollitz, a senior fellow at the Kaiser Family Foundation. (Kaiser Health News is an editorially independent program of the foundation.)

It’s important to affirmatively pick a plan to make sure you’re getting the right coverage at the best price. Federal tax credits that help pay for premiums are pegged to low-cost silver plans, called benchmark plans. It’s critical that each year you run the numbers to determine how your premium tax credit could be affected by changes in the benchmark plan and how that affects what you will pay out of pocket for coverage. Even if you are assigned to the same plan, your costs could be different next year.

Auto-enrollment doesn’t take premiums or benchmark plan changes into account, said Stan Dorn, a senior fellow at Families USA, an advocacy group.

Last year, 2.8 million people were auto-enrolled. That’s nearly a quarter of the 12.2 million people who enrolled in marketplace plans during the open enrollment period that ran from Nov. 1, 2016, through Jan. 31, 2017.

People whose plans will be discontinued by their insurer next year have a little room to maneuver if they’re auto-enrolled on Dec. 16. Because their plan will no longer be offered, that’s considered a loss of coverage, which triggers a 60-day special enrollment period. They can pick a plan through the end of February.

“But you have to pay the premium [on your existing plan], or you’ll have a gap in coverage,” said Pollitz, a risk that potentially exposes people to a penalty for not having insurance.

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