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13 qualifying life events that trigger ACA special enrollment
Outside of open enrollment, a special enrollment period allows you to enroll in an ACA-compliant plan (on or off-exchange) if you experience a qualifying life event.

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Finalized federal rule reduces total duration of short-term health plans to 4 months
A finalized federal rule will impose new nationwide duration limits on short-term limited duration insurance (STLDI) plans. The rule – which applies to plans sold or issued on or after September 1, 2024 – will limit STLDI plans to three-month terms, and to total duration – including renewals – of no more than four months.
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The Scoop: May 27, 2020 Edition

A look at state-level headlines regarding individual health insurance and health reform

For some Americans who lost coverage in the early rounds of layoffs due to COVID-19, a 60-day special enrollment window ends this weekend. | Image: memyjo /

Laid off in March? Your health insurance SEP might end soon

In the last two and a half months, about 39 million Americans have lost their jobs as a result of COVID-19. Since employer-sponsored coverage is the most common form of health insurance in the U.S., many of these people have also lost their health coverage in the midst of a pandemic. Loss of a health insurance plan triggers a special enrollment period during which they can purchase a new plan, but that window is only open for 60 days after the old plan ends. For people in the early rounds of layoffs – whose health coverage ended on March 31 – that 60-day window ends this weekend, on May 30.
There are still several states that are allowing anyone who is uninsured – regardless of whether they recently lost coverage or not – to enroll in a health plan through the exchange. These windows end June 15 in Maryland, New York, and Vermont; June 23 in Massachusetts, June 30 in California, and September 30 in Washington, DC. After those windows close, residents will need a qualifying event in order to sign up for 2020 health coverage. Loss of another health plan is a qualifying event, but you have to enroll within 60 days.

Washington’s exchange will have 13 insurers for 2021, up from nine this year

Last year, there were seven insurers offering plans in Washington’s state-run health insurance exchange. That group increased to nine this year, and four more insurers are joining the exchange for 2021, bringing the number of participating insurers to 13. All areas of the state will have at least two participating insurers – a far cry from the situation Washington was facing just a few years ago, when Insurance Commissioner Mike Kreidler had to scramble to convince insurers to cover counties that would otherwise have had no coverage options at all.
The proposed premiums for Washington’s individual market will be published next week. Insurers in Washington’s exchange will offer standardized health plans for the first time in 2021. (They also have the option to offer non-standardized plans.) Also, public option plans will be available in the exchange when open enrollment starts in November.

Oregon exchange will have six insurers for 2021

Regence – one of the insurers planning to join the exchange in Washington State – is also planning to join the exchange in Oregon for 2021. The number of insurers on Oregon’s exchange will increase from five to six, and three of them plan to offer coverage statewide. Insurers in Oregon have mostly proposed modest single-digit rate increases for 2021, and regulators note that the state’s reinsurance program continues to play a significant role in keeping premiums in the individual market lower than they would otherwise be.

Michigan health insurers announce premium credits to address lower claims due to COVID-19

Overall health insurance claims are down because so many elective medical procedures have been canceled or delayed as a result of COVID-19, resulting in lower costs for insurers. Earlier this month, we told you about health insurers – including Priority Health in Michigan – that had announced they would be giving premium credits to their enrollees due to a reduction in claims costs. Other Michigan insurers have made similar announcements in the last several days, including Health Alliance Plan (HAP) and Blue Cross Blue Shield of Michigan.
Numerous dental plans across the country are also offering premium credits to their individual and group enrollees, due to the sharp reduction in non-emergency dental care.

New Mexico cracks down on deceptive marketing practices for limited-benefit health plans

New Mexico’s Insurance Commissioner, Russell Toal, is taking action to address misleading marketing tactics that are sometimes used to sell limited-benefit health plans. In a bulletin issued last week, the Commissioner lists various deceptive practices that will not be tolerated, including anything that attempts to portray limited-benefit plans as comprehensive major medical coverage, especially in the midst of a pandemic.
Agents who market limited-benefit plans in New Mexico are required to inform clients about how these plans differ from comprehensive, ACA-compliant coverage, and are also required to provide clients with New Mexico’s Coverage Options Flyer, which explains how the state is making comprehensive coverage available to any applicant. New Mexico opened its high-risk pool to uninsured residents very early in the COVID-19 response, and that continues to be an option for people who aren’t eligible for Medicare, Medicaid, or a special enrollment period to buy a plan in the health insurance exchange.

Medicaid expansion will be on August 4 primary ballot in Missouri

Missouri is one of 14 states where Medicaid has not yet been expanded, but voters will get a chance to decide the issue this year. Last week, the Secretary of State certified the signatures that were submitted in order to get a Medicaid expansion initiative on the ballot. However, Governor Mike Parson announced this week that the measure will be on the August 4, 2020 primary ballot, instead of the general election ballot. Parson, who is opposed to Medicaid expansion, says that the earlier election will give the state more time to implement Medicaid expansion if voters approve it. But supporters of Medicaid expansion claim that Parson is hoping the lower turnout primary election will make it less likely that the measure will pass.
Oklahoma’s governor recently did the same thing with the citizen-led Medicaid expansion ballot initiative, scheduling it for the primary election in June instead of the general election. Oklahoma’s governor also surprised lawmakers last week when he vetoed a bill that would have funded the alternative Medicaid expansion plan that he had proposed earlier this year. Some lawmakers believe the governor’s veto will make it more likely that the Medicaid expansion ballot initiative will pass next month.
Over the last few years, Medicaid expansion ballot initiatives have passed in Maine, Idaho, Utah, and Nebraska.

Virginia governor vetoes legislation that would have allow self-employed to enroll in association health plans

Virginia’s governor has recently gone back and forth with lawmakers over the issue of allowing self-employed people to enroll in association health plans. The proposal would have been a stretch, as the Virginia Bureau of Insurance had already told lawmakers that they were unlikely to be able to use a 1332 waiver to obtain federal approval for the rule change. And Governor Northam had recommended that lawmakers reconsider the measure next year. But the legislature ultimately sent the bill back to Northam in April and he vetoed it last week.

IRS sets HSA rules for 2021, including contribution limits, minimum deductibles, maximum out-of-pocket

The IRS has published its annual guidance for HSA-qualified high-deductible health plans (HDHPs):

  • People with HDHP coverage in 2021 will be able to contribute up to $3,600 to an HSA if their HDHP provides self-only coverage, and up to $7,200 if their HDHP covers at least one other family member.
  • The minimum deductibles for HDHPs will remain unchanged, at $1,400 for self-only coverage and $2,800 for family coverage (note that insurers can still increase deductibles from 2020 to 2021; it’s only the minimum threshold that’s unchanged).
  • The maximum allowable out-of-pocket limit for HDHPs will be $7,000 for an individual and $14,000 for a family. These amounts will be quite a bit lower than the caps that apply to non-HDHPs ($8,550 and $17,100, respectively). In 2014, when the limits for HDHPs and non-HDHPs were equal, HDHPs tended to be among the least-expensive plans available. But that’s increasingly no longer the case, as there tend to be lower-cost plans available in most areas with out-of-pocket maximums that are too high to be HDHPs.

Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for

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