CMS – Centers for Medicare & Medicaid Services announces new Special Enrollment Period for 2015 Tax Season

Eligible consumers have from March 15 through April 30 to enroll in coverage

On February 20, 2015, the Centers for Medicare & Medicaid Services announced yet another new Special Enrollment Period (SEP) for individuals and families who did not have health coverage in 2014 and are subject to the fee or “shared responsibility payment” when they file their 2014 taxes in states which use the Federally-facilitated Marketplaces (FFM). 7 states including Illinois, have a state-federal partnership exchange. A state-federal partnership exchange is a federally facilitated exchange until such time that the state chooses to adopt the responsibilities required to run their own state-based exchange. As of this writing, Illinois has not chosen to do so.

This Special Enrollment Period will allow those individuals and families who were unaware or did not understand the implications of this new requirement to enroll in 2015 health insurance coverage through the FFM. For those who were unaware or did not understand the implications of the fee for not enrolling in coverage, CMS will provide consumers with an opportunity to purchase health insurance coverage from March 15 to April 30.  If consumers do not purchase coverage for 2015 during this special enrollment period, they may have to pay a fee when they file their 2015 income taxes. As of this writing, Blue Cross Blue Shield of Illinois has not decided as to whether or not they will offer off the exchange applications during this new Special Enrollment Period. If and when they do, I will update this post.

Those eligible for this special enrollment period live in states with a Federally-facilitated Marketplace and:

  • Currently are not enrolled in coverage through the FFM for 2015,
  • Attest that when they filed their 2014 tax return they paid the fee for not having health coverage in 2014, and
  • Attest that they first became aware of, or understood the implications of, the Shared Responsibility Payment after the end of open enrollment (February 15, 2015) in connection with preparing their 2014 taxes.

The special enrollment period announced today will begin on March 15, 2015 and end at 11:59 pm E.S.T. on April 30, 2015.  If a consumer enrolls in coverage before the 15th of the month, coverage will be effective on the first day of the following month.

Other than this 45 day window, the only way to get health insurance that covers preexisting conditions before 2016 is if you qualify under the normal rules of Special Enrollment. Click ‘Start Shopping Now’ to explore Special Enrollment options. If you are in Illinois and need guidance call (630) 674-1551. Outside of Illinois, call toll free at (866) 724-7123.

Read the full CMS announcement here.

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