Health insurance open enrollment starts Nov. 1, and Maine’s insurance superintendent is encouraging residents and businesses to look at their insurance needs and options.
“Individuals and families who purchase their own health insurance should review their options each year,” Superintendent Eric Cioppa said in a recently released statement. “Changes in household income or size can impact whether an individual or family qualifies for tax credits. Also, Mainers should not assume that the plan they currently have is the best option for 2016.”
The 2010 Affordable Care Act, also known as Obamacare, requires most Americans to carry health insurance. Individuals and families can purchase their own insurance only during a specific open enrollment period unless they experience a life-changing event, such as a job loss or the birth of a child.
The next open enrollment period runs from Nov. 1 to Jan. 31, 2016.
In Maine, individual and family plans will be sold by Aetna, Anthem, Harvard Pilgrim Health Care/HPHC and Community Health Options, formerly known as Maine Community Health Options.
All plans will be available on the federal insurance marketplace at Healthcare.gov. Insurance may also be purchased outside of the marketplace, but subsidies and tax credits apply only to plans bought through the marketplace.
Mainers who bought insurance through Healthcare.gov in 2015 will receive a marketplace notice asking them to update their income and household information. That information is used to calculate subsidies and tax credits.
Mainers will also receive a notice from their insurance company about any changes to their current plan, including cost. Policyholders who take no action will be automatically re-enrolled in their current plan. If their current plan is no longer available, they will be enrolled in a new plan.
Information about plans offered on and off the marketplace can be found at the Bureau of Insurance website Maine.gov/insurance, by calling the bureau at 1-800-300-5000 or by emailing Insurance.PFR@maine.gov.
Small businesses can buy insurance any time, but a special open enrollment period allows them to do so without meeting minimum participation requirements. That open enrollment period will run from Nov. 15 to Dec. 15.
Anthem, Harvard Pilgrim Health Care and Community Health Options will offer plans through the small business marketplace called Small Business Health Options, or SHOP. Aetna, Anthem, Harvard Pilgrim Health Care/HPHC, Community Health Options and United Health Care Insurance will offer small group plans outside SHOP.
For more information, employers can request the Guide to Small Business Insurance in Maine from the Maine Bureau or view it on the bureau’s website. They can also contact the bureau with questions.
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