What You Need to Know for Special Enrollment

As many of you already know, there is a tax penalty for being uninsured that was supposed to go into effect in 2015. However, Covered California is now extending the deadline to enroll in coverage for people who did not know or realize they would be penalized in 2015 for being uninsured. Therefore, California is allowing consumers to apply for health insurance thru April 30, 2015 during the “Special Enrollment” period only if they they can prove that they did not realize there was a penalty.

How do you prove that you were unaware of the penalty? Consumers have to select “Informed of Tax Penalty Risk” on the dropdown menu when they apply for Special Enrollment here.

Typically, consumer can only enroll in Special Enrollment throughout the year if there is a qualifying life event. 

Qualifying Events:

  • Marriage
  • Having a Child/Adopting a Child/Foster Care
  • Moving Homes (ie: you move into a different state of coverage options or a different city of providers)
  • Loss of Health Coverage (job, divorce, etc.)
  • Change in Income (must prove that the change in income makes the cost of current coverage unaffordable)
  • Change in Citizenship
  • More Qualifying Events

How do you apply for Special Enrollment?

  1. Within the first 60 days of the qualifying event, you must enroll in a Covered California health plan or change your existing plan. If you don’t sign up for health coverage within those first 60 days, you could be facing a tax penalty and you have to wait until the next open enrollment period.
  2. You can apply online or call the Covered California Service Center.
  3. Typically, coverage starts on the 1st or 15th of the month so it’s important to plan ahead to avoid any periods without coverage. If you enroll in coverage before the 15th of the month, it will become active on the 15th. If you enroll in coverage after the 15th of the month, coverage will start on the first of the following month.

If you have any questions regarding the Special Enrollment period, qualifying events, or the 2015 tax penalty, please feel free to contact us.

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