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Seven Tips to Navigate Health Reform

CMS Announces Special Enrollment Period for Tax Season

Eligible consumers have from March 15 through April 30 to enroll in coverage


The Centers for Medicare & Medicaid Services (CMS) announced today a special enrollment period (SEP) for individuals and families who did not have health coverage in 2014 and are subject to the fee or “shared responsibility payment” when they file their 2014 taxes in states which use the Federally-facilitated Marketplaces (FFM). This special enrollment period will allow those individuals and families who were unaware or didn’t understand the implications of this new requirement to enroll in 2015 health insurance coverage through the FFM.

For those who were unaware or didn’t understand the implications of the fee for not enrolling in coverage, CMS will provide consumers with an opportunity to purchase health insurance coverage from March 15 to April 30.  If consumers do not purchase coverage for 2015 during this special enrollment period, they may have to pay a fee when they file their 2015 income taxes.

Those eligible for this special enrollment period live in states with a Federally-facilitated Marketplace and:

  • Currently are not enrolled in coverage through the FFM 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.

The special enrollment period announced today will begin on March 15, 2015 and end at 11:59 pm E.S.T. on April 30, 2015.  If a consumer enrolls in coverage before the 15th of the month, coverage will be effective on the first day of the following month.

Here are seven vital tips to navigate health reform for 2015 and beyond. Be sure to download the PDF flier with this information to print and share.

ONE:  As of January 1, 2014—All new plans on or off the federal exchange marketplace are guaranteed issue with no exclusion of pre-existing conditions—which means the insurance company cannot deny you for coverage and they can’t exclude any of your medical conditions.

Click on this image to download a PDF handout with these Seven Tips!

Click on this image to download a PDF handout with these Seven Tips!

TWO:  All Americans will be required to purchase health insurance, or pay a penalty. This penalty increases every year. In 2015 it’s two percent of income or $325 per person, whichever is greater. In 2016 and later years it’s 2.5 percent of income or $695 per person, whichever is greater. After that it’s adjusted for inflation.

THREE: The Open Enrollment Period (OEP) ended on 02/15/2015. If you missed this deadline, you will not be able to enter the system until 2016, unless you qualify for a special enrollment period (SEP).

FOUR:  If you have a non-Affordable Care Act (ACA) health plan  you have the choice to keep it for at least another year. This is referred to as “grandmothering.”

FIVE: Prices for ACA plans are expected to cost significantly more than plans today due to Health Reform mandates. The ACA plans are richer plans, more robust than plans prior to 12/31/2013, and therefore will cost more.

SIX: If you are making under $47,080 (single), $63,720 (couple) or $97,000 (family of 4) will receive federal subsidy to help you pay for your health insurance. If you are eligible for a subsidy, your broker will assists you in purchasing your health plan on the exchange marketplace.

SEVEN: The amount you pay for insurance will NOT be determined based on your health history. Every one of the same age, in the same zip-code, will pay the same amount. Except for smokers who will pay a lot more.

did you know

To have knowledge is to be empowered. We welcome the chance to empower you. We can also be found on many of the social media sites: Facebook, Pinterest, LinkedIn, and Twitter.

matt_81x106Matthew Byrne has made a career helping people find affordable health insurance in Ohio. He is the founder of, a Dublin-based brokerage providing Ohio health insurance quotes and services for individuals, families and corporations. Mr. Byrne is a subject matter expert speaking frequently about Health Care Reform, Defined Contribution Programs, COBRA, and Medicare. He can be reached at (614) 336-3636, and online at

Need a Health Reform Speaker? Find Matt on COPEC!

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