Extended Coverage of Health Insurance

by | May 25, 2021 | Blog, Health Insurance

Extended Coverage for Marketplace Health Insurance Customers

The term “Marketplace Health Insurance” is used to describe the assortment of plans offered on the federal health insurance exchange. Insurance companies offer Qualified Health Plans that comply with the standards set by the Affordable Care Act. Qualified plans include a subsidy from the Federal government paid to the insurance company to decrease the costs of a customer’s monthly premium and out-of-pocket costs. Subsidy level is determined by yearly taxable income.

The Department of Health and Human Services recently announced an extension of the special enrollment period for Marketplace plans through August 15, 2021. During this enrollment period, customers can switch health plans or enroll in a Marketplace plan for the first time. The American Rescue Plan, passed into law March of 2021, included enhanced premium tax credits for Marketplace customers. Current customers are encouraged to submit an updated application to see if they would be eligible for additional credits. Customers who received unemployment for at least one week during 2021, will be eligible for $0 premium plans with the highest level of cost-sharing reductions. It was also announced that 2020 Marketplace customers who owed advanced premium tax credits after a change in income would not have to pay back the credits on their taxes.

Extended Coverage for COBRA Continuation Health Coverage Customers

The term “COBRA” refers to the Consolidated Omnibus Budget Reconciliation Act of 1986, which requires group health plans to provide a temporary continuation of the group health coverage that would otherwise be terminated after an employee leaves a company. COBRA applies to all group health plans offered by local or state governments, as well as private employers with 20 or more employees. An employee covered by COBRA can maintain their health insurance for a limited period of 18 or 36 months. The employee would be responsible for paying 100% of the premium costs for the coverage extension.

The American Rescue Plan approved 100% subsidy for COBRA premiums as of April 2021, through September 30, 2021, for employees who lost their job. This protection does not cover employees who willingly left their jobs or who lost a job due to gross misconduct. This means that employees who elect COBRA will remain covered, under the same group plan, for $0 premium for this six-month period. The Rescue Plan also announced a new 60-day enrollment period, allowing employees the option to enroll in COBRA even if they originally declined the coverage, willingly un-enrolled from the coverage, or if initial enrollment window was expired.

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