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"Limited" ACA Special Enrollment for WA Residents

Sep 11, 2014

Up to 8% of the 164,000 Health Exchange customers of the Washington HealthPlanFinder experienced on-going billing and administrative problems. This caused some Washington residents to go without insurance, lose their coverage, or become insured under the wrong plans.

Limited Special Enrollment Period: As a consequence, the Washington State insurance commissioner created a “limited” special enrollment period (began August 27 and ends November 14, 2014) for those people who had difficulty enrolling in health coverage through Washington Healthplanfinder and for those who had billing or payment issues with the exchange.  This special enrollment period enables affected existing exchange members to enroll directly with their current insurance company or a new company outside the exchange (or make a change within the exchange if they so choose).

The Washington Health Benefit Exchange (the Exchange), also known as the Washington Healthplanfinder, is making progress to correct the enrollment and payment difficulties that have affected some consumers. Those fixes are continuing, but may take additional time to resolve. So, this temporary special enrollment period gives consumers who have struggled with their coverage an opportunity to reset their coverage or select another plan, either inside or outside the Exchange. This coverage would remain in effect through the end of 2014.

During the temporary special enrollment period, you can:

  • Stay with your health insurer but switch to a plan sold outside of the Exchange,
  • Stay with your current health insurer inside the Exchange, or
  • Switch to a new health insurer inside or outside of the Exchange.

If you move to a new insurer or to the same insurer outside of the Exchange, you must select a plan with the same metal level that you have today. However, if you enroll in a plan outside of the Exchange, you will not get a premium or cost-sharing subsidy, even if you qualify for one. Subsidies are only available for health plans purchased through Washington Healthplanfinder. Of course, you can choose to keep your current health insurer and pay through the Exchange or pay your health insurer directly. Anyone with Washington Apple Health in not eligible for this temporary special enrollment.

Special enrollment is voluntary and may not be the right choice for everyone. You can qualify for the special enrollment if you have been unable to get or keep coverage through the Exchange because the Exchange made an error in your enrollment, billing, or premium payment since Oct. 1, 2013. You must make an attestation that you have experienced difficulties and wish to take this option to find new coverage.

This special enrollment will last through November 14, 2014, at the latest. The commissioner may decide to end this special enrollment sooner if the Exchange resolves its issues. After November 14, the general open enrollment period for 2015 plans starts and runs through Feb. 15, 2015. During this time, you'll need to either re-enroll in your current plan or select a new plan for 2015.

For no-cost assistance please Contact Us.  One of our exchange certified Health Insurance Agents is ready to assist you. 

Source: Washington State Office of the Insurance Commissioner, News Release – August 28, 2014

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