Q. If I don’t make changes to my plan and just let it auto-renew for January, am I stuck with it for the rest of the year?
A. Yes, unless you experience a qualifying event later in the year.
Open enrollment for 2019 coverage began on November 1, 2018, and ended on December 15, 2018 in nearly every state. There are seven state-run exchanges that extended their open enrollment windows; everywhere else, open enrollment ended December 15.
So in most states, open enrollment ended before the start of 2019, with all plans selected during open enrollment taking effect on January 1. Prior to 2018, open enrollment extended into January, allowing people the opportunity to switch plans after the start of the year. But that’s no longer an option in most states unless you have a qualifying event.
If your health plan terminated at the end of 2018 and you’re mapped to a new plan for 2019, you may have a special enrollment period that continues for 60 days after your plan ended (so, until March 1, 2019), during which you can pick from among any of the available options in your area. But this is limited to situations in which the insurer exited the exchange or the full individual market in your area, or made a major change to plan designs, such as switching everyone from PPOs to HMOs.
Changes to the benefit structure itself would not warrant a special enrollment period. Although there were widespread insurer exits in 2017 and 2018, as well as transitions away from the PPO model, the market is much more stable for 2019, with insurer exits almost non-existent. That said, some insurers are adjusting their coverage areas in some states, which would result in loss of coverage for people in counties where the insurer offered plans in 2018 but is no longer offering them for 2019. People in that situation will qualify for this special enrollment period in early 2019.
Shorter open enrollment was new for 2018
Open enrollment for 2016 and 2017 followed a November 1 – January 31 schedule, and was slated to be the same for 2018 coverage as well. After that, starting with enrollment in the fall of 2018 (for 2019 coverage) it was scheduled to switch to November 1 – December 15. But in April 2017, HHS finalized a market stabilization rule that included a switch to the shorter open enrollment period one year early — in the fall of 2017 instead of 2018.
Going forward, open enrollment will continue to follow the November 1 – December 15 schedule, with coverage effective January 1.