Important Special Enrollment Period Update

Posted by Phil Dougherty
February 20, 2020

The Open Enrollment period to enroll in ACA compliant health insurance in CA is over; that ended January 31. Special Enrollment is a provision in the ACA law that protects those that have a disruption (called a Qualifying Event) in their existing health insurance outside of the Open Enrollment period. Common among these events include the loss of group insurance, the exhaustion of COBRA, and moving to another state. In most cases, you’ll have 60 days prior to the qualifying life event and 60 days after the event to enroll in available ACA compliant insurance with the effective being the first of the month following your enrollment, but no earlier than the date of the qualifying event. Here is more information about qualified life events and eligibility: Qualifying Life Events for special enrollment. Contact our office about your specific situation to learn more about the options available.

Anthem Blue Cross grandfathered members: Unique to some states including California is a qualifying event that protects those who are impacted by a rate increase to their grandfathered health plans. Grandfathered plans were those in place prior to when the ACA law took effect and didn’t have to comply with many of the ACA requirements. In California, Anthem Blue Cross will have an April 1, 2020 rate increase on their remaining grandfathered plans. Those effected by this increase will qualify for special enrollment and be allowed move to any ACA complaint plan if they wish with the enrollment period being the same as stated above. Contact us for more information about this special enrollment opportunity.

New Short Term Special Enrollment: California has just announced a new special enrollment opportunity for those who remain unaware of the new state subsidy and new state penalty. With the federal government removing the penalty for not carrying qualified insurance, California has installed their own penalty for those residents who do not carry compliant insurance in 2020. In addition, Covered California, the state’s public marketplace, has added new state subsidies that goes beyond what the Affordable Care Act’s financial assistance provides. Those “uninformed” of these new changes can take advantage of this special short term enrollment opportunity through April 30, 2020. Specifically, this allows the uninsured additional time to enroll in coverage (and avoid a penalty) and those currently insured in the private market who wish to enroll through Covered California to take advantage of new state subsidies. For more information and assistance about this enrollment opportunity, visit:

Happy to answer your questions.

Phil Dougherty