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Annual enrollment

From Wikipedia, the free encyclopedia

In the United States, annual enrollment (also known as open enrollment or open season) is a period of time, usually but not always occurring once per year, when employees of companies and organizations, including the government,[1] may make changes to their elected employee benefit options, such as health insurance. The term also applies to the annual period[2] during which individuals may buy individual health insurance plans through the online, state-based health insurance exchanges established by the Patient Protection and Affordable Care Act. Prior to January 1, 2014 insurers offering individual medical coverage typically allowed new members passing underwriting to enroll at any time throughout the year.

Annual enrollment is also prominent in Medicare, where almost 50 million enrollees can choose to stay in original Medicare, or join or change plans within the Medicare Advantage and Medicare Part D Prescription Drug programs for the coming calendar year. Individuals usually can make changes to, or sign up for, their health insurance or fringe benefits only once per year[2] during the annual enrollment period or when they have experienced a specific qualifying event.[3] Open enrollment periods are used in insurance markets to limit adverse selection risks resulting when enrollees can switch plans at will.[4]

During this time period, an employer will typically communicate to all eligible employees what options they have for their benefit program. Often the vendors or insurance providers will be present to explain the details of their products. This can be done either with group presentations, "benefit fairs" or meetings one on one with each employee. As travel expenses continue to rise many vendors and insurance providers have turned to using independent "contract enrollers" to do the communication on their behalf. Some companies and organizations distinguish between an active enrollment benefits election period, where employees must re-review or confirm their benefits selections for the coming year, and a passive enrollment benefits election period, where employees are automatically renewed with their existing benefits selections from the current year if no action is taken.[5]

Open season is a prominent feature of the Federal Employees Health Benefits Program during which some three million federal civilian employees and retirees may choose among several dozen health insurance plans[1] for the coming year. Open season is scheduled in the fall each year, and plan enrollment decisions take effect in the following calendar year.

Under the Patient Protection and Affordable Care Act

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Under the Patient Protection and Affordable Care Act, annual enrollment, or open enrollment, is the period that people in the United States who need health insurance can sign up for an individual insurance plan. Unless someone experiences a "qualifying event" (a change in personal circumstances such as getting married or having a baby[6]) outside of the annual enrollment period, annual enrollment is the only time to sign up for individual health insurance under the Affordable Care Act. Annual enrollment used to last for three months; the 2016 cycle lasted from November 1, 2015 to January 31, 2016. The 2018 annual enrollment cycle was reduced to 45 days (in most states) from November 1, 2017 to December 15, 2017.[7]

Acting during the annual enrollment period is vital for any individual who wishes to buy individual health insurance. During annual enrollment anyone who wants to purchase insurance through the public exchange has the opportunity to do so despite circumstances, such as health or age. Outside annual enrollment, it can be difficult to obtain insurance, either public or private unless circumstances dictate.[8]

States open enrollment dates for 2025 coverage

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State Enrollment date
Alabama November 1, 2024 – January 15, 2025
Alaska November 1, 2024 – January 15, 2025
Arizona November 1, 2024 – January 15, 2025
Arkansas November 1, 2024 – January 15, 2025
California November 1, 2024 – January 31, 2025
Colorado November 1, 2024 – January 15, 2025
Connecticut November 1, 2024 – January 15, 2025
Delaware November 1, 2024 – January 15, 2025
Florida November 1, 2024 – January 15, 2025
Georgia November 1, 2024 – January 15, 2025
Hawaii November 1, 2024 – January 15, 2025
Idaho October 15, 2024 – December 15, 2024
Illinois November 1, 2024 – January 15, 2025
Indiana November 1, 2024 – January 15, 2025
Iowa November 1, 2024 – January 15, 2025
Kansas November 1, 2024 – January 15, 2025
Kentucky November 1, 2024 – January 15, 2025
Louisiana November 1, 2024 – January 15, 2025
Maine November 1, 2024 – January 15, 2025
Maryland November 1, 2024 – January 15, 2025
Massachusetts November 1, 2024 – January 23, 2025
Michigan November 1, 2024 – January 15, 2025
Minnesota November 1, 2024 – January 15, 2025
Mississippi November 1, 2024 – January 15, 2025
Missouri November 1, 2024 – January 15, 2025
Montana November 1, 2024 – January 15, 2025
Nebraska November 1, 2024 – January 15, 2025
Nevada November 1, 2024 – January 15, 2025
New Hampshire November 1, 2024 – January 15, 2025
New Jersey November 1, 2024 – January 31, 2025
New Mexico November 1, 2024 – January 15, 2025
New York November 1, 2024 – January 31, 2025
North Carolina November 1, 2024 – January 15, 2025
North Dakota November 1, 2024 – January 15, 2025
Ohio November 1, 2024 – January 15, 2025
Oklahoma November 1, 2024 – January 15, 2025
Oregon November 1, 2024 – January 15, 2025
Pennsylvania November 1, 2024 – January 15, 2025
Rhode Island November 1, 2024 – January 31, 2025
South Carolina November 1, 2024 – January 15, 2025
South Dakota November 1, 2024 – January 15, 2025
Tennessee November 1, 2024 – January 15, 2025
Texas November 1, 2024 – January 15, 2025
Utah November 1, 2024 – January 15, 2025
Vermont November 1, 2024 – January 15, 2025
Virginia November 1, 2024 – January 15, 2025
Washington November 1, 2024 – January 15, 2025
Washington DC November 1, 2024 – January 31, 2025
West Virginia November 1, 2024 – January 15, 2025
Wisconsin November 1, 2024 – January 15, 2025
Wyoming November 1, 2024 – January 15, 2025

Source:[9]

See also

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References

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  1. ^ a b "Open Season". U.S. Office of Personnel Management. Retrieved 2020-10-27.
  2. ^ a b "State Enrollment Deadlines". Annual Open Enrollment. 2020-09-25. Retrieved 2020-10-27.
  3. ^ "2020 Medicare Annual Enrollment Period". MedicareFAQ. Retrieved 2020-05-21.
  4. ^ Decarolis, Francesco; Guglielmo, Andrea; Luscombe, Calvin (2017). "Open Enrollment Periods and Plan Choices". National Bureau of Economic Research, No. W24156. doi:10.3386/w24156. S2CID 168942702.
  5. ^ Miller, Stephen (8 September 2017). "Open Enrollment: Active vs. Passive Benefits Election". SHRM. Retrieved 15 November 2021.
  6. ^ "Qualifying Life Event (QLE) - HealthCare.gov Glossary". HealthCare.gov. Retrieved 2022-02-14.
  7. ^ "Official Marketplace Dates and Deadlines". HealthCare.gov.
  8. ^ Affordable Care Act - Open Enrollment Eventus Solutions, November 2014
  9. ^ "ACA Open Enrollment 2025 Guide". healthinsurance.org. 2024-08-22. Retrieved 2024-09-19.


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