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CPBJ Extra Blog

Open enrollment outside

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As I write this on Tuesday, Jan. 21, 2014 — yes, I do these in advance — there is one Obamacare deadline that still stands stalwart: March 31, 2014, the end of open enrollment for individual coverage from

That's the last day you can get a non-Medicaid plan for 2014 on, unless you have a qualifying life event. It's also the deadline for avoiding the individual mandate penalty; beyond then, if you don't have qualifying health care coverage or an exemption, the penalty starts kicking in (it's pro-rated).

But what about plans outside, the ones you buy directly from insurers and can't get a subsidy for? Are they on the same timeline?

The answer was harder to ferret out than I expected, and it is: Maybe.

"An insurer 'may' limit enrollment to an open enrollment period and the rule applies both on and off exchange," said Pennsylvania Insurance Department spokeswoman Rosanne Placey. "Not exactly sure what all the business practices are on that — it likely varies from insurer to insurer."

Indeed, it does. I have answers from two insurers so far, as follows.

• Capital BlueCross. Spokesman Joe Butera: "There is an open enrollment period for our (non-federal exchange/marketplace) individual policies. It is the same timing as the open enrollment period for the public marketplace, which ends the end of March (at least for now)."

• Highmark. I asked spokesman Leilyn Perri the following extremely leading question: "What I'm understanding you to say is that Highmark is not setting an open enrollment period — that although the enrollment for 2014 ends March 31, if people wanted to buy insurance directly from Highmark, they could do it on, say, July 17 or Aug. 5 or Sept. 29 and have coverage starting shortly thereafter. Is that correct?" He said yes.

I suspect this one is a hard decision for insurers. On one hand, insurers generally want policyholders; on the other, they aren't particularly wild about acquiring policyholders who are going to cost them a lot of money — and which category do you think people who decide to get a plan after March 31 will occupy?

But then again, people on the individual marketplace have traditionally been used to buying policies whenever they wanted to, and from what I hear, health insurance calls for a pretty long-term game these days.

It's a whole new world out there, folks.

• • •

Finally, here are links to some of the best and most helpful things I read this week.

Reform, new labor issues likely to keep unions busy in 2014

Rules for Equal Coverage by Employers Remain Elusive Under Health Law

How Aetna's CEO thinks about Obamacare

How does the mini-med loophole work?

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