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QSEHRA

Do I qualify for a 1.1.2022 start even though the deadline has passed?

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Amy •

Missed the open enrollment deadline? A few people will have unique circumstances that allow them to enroll in an insurance plan that begins January 1, 2022, despite the fact that the Jan. 1 enrollment cutoff has passed. Do you fall under these special circumstances? Read more to find out. 

**This post is updated daily to reflect deadline changes as they are announced for 2022. Last update Dec. 16, 2021** 

If you are stressed about missing the December 15th open enrollment deadline for Jan. 1 coverage and are hoping for coverage starting on January 1st, you may be in luck. While open enrollment extends to Jan. 15th in most places, remember that for plans starting on Jan. 1, the overwhelming majority of cases have a deadline of Dec. 15th. 

There are two primary reasons why someone would qualify to purchase an individual plan that begins on January 1, 2022 despite missing the Open Enrollment deadline. The first circumstance would be individuals who are new hires in the month of December. The second reason is if you live in one of the states that have given their citizens a bit more time to choose a plan. 

Helpful resource → A complete list of enrollment deadline extensions by state. 

December 15th is the cutoff for Jan. 1 coverage unless there's a state specific extension or you qualify for a Special Enrollment Period.

 

Two reasons why you might have extra time:

1.) If you are a new employee
2.) If you live in a state that has extended open enrollment dates

If you're a new employee...

If you just started a new job and are looking to sign up for health insurance that begins January 1st, you're in luck. Starting a new job qualifies as a Special Enrollment Period, which means you'll have 60 days to sign up for a new plan. So if you began your job in November or December, you can sign up any time before December 31st for plans starting at the first of the year, regardless if the December 15th deadline has passed. 

Special note: For new employees looking to shop for a health plan in their Special Enrollment Period, you'll need to go to Healthcare.gov or your state exchange rather than shopping on our platform. 

Here's what to do.

For all other states, shop for a plan on Health Sherpa.

 

If you live in a state with extended open enrollment...

For states that have their own state-based exchange, they can set their own cutoff dates, meaning they don't have to comply by the December 15th cutoff if they don't want to. That means if you live in one of those states, you have more time to consider your health insurance options for 2022 than the rest of the country. 

The states that have extended open enrollment dates for Jan. 1, 2022 coverage include:

  • California
  • Connecticut
  • Idaho
  • Kentucky
  • Massachusetts
  • Nevada
  • New Jersey
  • Pennsylvania
  • Rhode Island
  • Washington DC

Below is a chart that shows the state-specific cutoffs for Jan. 1, 2022 coverage. 

State Deadline for 1/1 start
California 12/31/21
Connecticut 12/31/21
Idaho 12/22/21
Massachusetts 12/23/21
Nevada 12/31/21
New Jersey 12/31/21
Pennsylvania 12/22/21
Rhode Island 12/31/21
Washington DC 12/31/21

Special note: For new employees looking to shop for a health plan in their Special Enrollment Period, you'll need to go to your state exchange rather than shopping on our platform. 

What happens if I missed the deadline for open enrollment and neither of the above scenarios apply to me? 

Don't panic. You might have options, depending on what type of HRA you are being offered through your company.

If your employer offers you a QSEHRA, our team can help you look into alternative plans (like sharing ministries, for example) to couple with an individual / preventative MEC plan. These costs will be reimbursable through your QSEHRA. More on those options here. 

If you are being offered an ICHRA and missed the December 15th deadline, check to see if you qualify for a special enrollment period, which gives you a 60-day window to change or sign up for coverage. Here's a full list.

You qualify for an SEP if you: 

  • Got married.
  • Had a baby, adopted a child, or placed a child for foster care. Your coverage can start the day of the event — even if you enroll in the plan up to 60 days afterward.
  • Changed residence (must move to a different zip code)
  • Started a new job
  • Got divorced or legally separated and lost health insurance. Note: Divorce or legal separation without losing coverage doesn’t qualify you for a Special Enrollment Period.
  • Had a loss. You’ll be eligible for a Special Enrollment Period if someone on your Marketplace plan dies and you’re no longer eligible for your current health plan as a result of their death.
  • Lost eligibility for Medicaid or the Children’s Health Insurance Program (CHIP)
  • Gained membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
  • Becoming newly eligible for Marketplace coverage because you became a U.S. citizen
  • Left incarceration
  • AmeriCorps VISTA members starting or ending their service

Important note: If you don't qualify for a special enrollment period due to one of the above circumstances, your best bet is to just choose an alternative plan of insurance (sharing ministry, short-term plans). Unfortunately, these alternatives won't be reimbursable under your company's ICHRA. You'll need to wait until next year's open enrollment to choose a compliant health plan to receive reimbursements. 

Need help? We're here for you.

If you have questions, just chat with us at the bottom right of your screen. You can also email us at support@takecommandhealth.com. We'd be happy to help you.

Happy open enrollment and happy holidays! 

QSEHRA

Amy

I wrote this blog because I care about ideas (big and little) that can help fix our healthcare system. I used to work on projects for Kaiser Permanente and the Parkland Health & Hospital System so I've seen the system inside and out. It's so important that consumers keep up with industry shifts and changing health insurance regulations. I'm also Take Command Health's Content Editor and a busy mom. Learn more about me and connect with me on our about us page. Thanks!

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