01/21/2011
Individual open enrollment periods for 2011
The Washington Office of the Insurance Commissioner (OIC) recently issued a new emergency rule establishing two individual health plan coverage open enrollment periods (OEPs) for young people. OEPs for children under the age of 19 must be held from March 15 to April 30, 2011, and from Sept. 15 to Oct. 31, 2011. Future clarification is expected as to when coverage elected during these periods would be effective.
This emergency rule replaces the previous OEP emergency rule, and will be effective until any permanent rule is adopted. A comment period is currently underway; however, there are not any major changes to the rule expected. In fact, the Washington OIC indicated that this approach is similar to comparable markets, including Oregon.
Additional information and other options
The Individual market serves people who don't have access to employer-sponsored health coverage. As we've communicated to you in the past, due to the new health care reform law, children under 19 years of age can't be denied coverage due to pre-existing health conditions. However, insurers may limit acceptance to OEPs, noted above.
If coverage is needed for children outside the noted OEP dates, application can be made either to the Washington State Health Insurance Pool (WSHIP) or, if the child qualifies, to the new Pre-existing Condition Insurance Plan (PCIP-WA). To enroll in PCIP-WA, you must have been uninsured for at least six months and have a pre-existing medical condition.
Additionally, Individual coverage enrollment for a child under age 19 is available outside an OEP:
- At the birth or adoption of the child
- If the child is no longer eligible for public program coverage
- When coverage is lost due to a divorce
- If employer-sponsored coverage is no longer available
- When a move takes place, and coverage is not available at the new location.
Questions can be directed to the following resources: Insurance Consumer Hotline at 1 (800) 562-6900; Regence Individual and Medicare Sales Producer Support line at 1(800) 557-0555 or your Regence sales representative.
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