Marketplace Update: Tax Season SEP

Western Region Brokers

The state and federally facilitated marketplaces are offering a Special Enrollment Period (SEP) for people who did not know or understand that there is a tax penalty for not having health insurance. In California, the SEP began February 23, 2015, and continues through April 30, 2015. In states like Arizona where the marketplace is federally facilitated, the SEP is March 15, 2015, through April 30, 2015.

 

Many Americans are doing their 2014 taxes and finding out that there’s a penalty for not having health insurance. The new tax penalty – also known as the “shared responsibility mandate” – applies to people who are not otherwise covered in a group plan and who do not buy health insurance and do not qualify for an exemption.

The limited-time SEP is for people who did not know or understand that there is a tax penalty for not having health insurance. It gives eligible consumers the opportunity to apply for 2015 coverage even though the Open Enrollment period is over for the year.

 

Specifics by State

California
Timeframe: February 23, 2015 – April 30, 2015.

Consumers who apply for coverage during this SEP must attest that they did not know or understand there was a tax penalty for being uninsured in 2014 or learned they may face a penalty for 2015.

 

Arizona, Oregon and other states with a federally facilitated marketplace
Timeframe: March 15, 2015 – April 30, 2015.

Those eligible for this SEP are those who:

  • Currently are not enrolled in coverage for 2015,
  • Attest that when they filed their 2014 tax return they paid the fee for not having health coverage in 2014, and
  • Attest that they first became aware of, or understood the implications of, the Shared Responsibility Payment after the end of Open Enrollment (February 15, 2015) in connection with preparing their 2014 taxes.

 

Standard Effective Dates

Applications received by the:

  • 15th of the month will be effective the first of the following month.
  • 16th of the month or later will be effective the first of the second following month.

 

As always, effective dates are dependent on receipt of the applicant’s first premium payment.

 

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Jennifer Moore