The open enrollment period cutoff date for individual health insurance in New York State both on and off exchange is 3/31/14.
Come 4/1/14, individuals will not be able to obtain or alter their current insurance until Nov 15th for a 1/1/15 change date.
Any enrollment submitted from now until 3/31/14 will have a 5/1/14 effective date.
The only way to enroll or change individual health insurance after the deadline is to qualify for a Special Enrollment Period through one or more criterion.
“We translated it from “legalese” so it’s easier to read, but feel free to read the law verbatim here: Title 45, Subtitle A, Subchapter B, Part 155, Subpart E, Section 155.420
There are 9 distinct events that can generate a SEP:
1. No-fault loss of Minimum Essential Coverage (Employer offered, Medicaid, or Chip)
2. Gaining a dependent through birth/ marriage/ adoption.
3. Gaining status as a citizen/ foreign national/ lawfully present alien.
4. You are a qualified individual who experienced an enrollment issue (subject to review, and can’t be the insured’s fault).
5. Change in income that makes an individual NEWLY eligible for subsidy, or a change in Cost Sharing Reductions (CSR) (specifically, a change in the amount of subsidy doesn’t count).
6. A permanent move of residence that offers new plan options.
7. Adequately prove to the exchange that the Insurer “substantially violated a material provision of it’s contract”.
8. Individual is an Indian (Native American, with government approved proof).
9. “Other exceptional circumstances, as determined by the Exchange or HHS” (I.E. a child with cancer will die if the plan can’t be switched).“