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Chamber Chatter

Open Enrollment for Individuals

Open Enrollment for individuals & families starts its 3rd year on November 1st and the time to purchase or change plans has been compressed into a 3-month period.

Here‘s what you need to know:

 To secure a January 1st effective date, you must enroll and pay for a plan by December 15th. (Just a 45 day period!) For example:

  • December 16th – 31st secures a February 1 effective date
  • To secure a February 1st effective date, you must enroll and pay for a plan by January 15th
  • January 16th – 31st, secures a March 1st effective date


If you miss Open Enrollment, the only way to purchase a Health Plan is by having a “Life Qualifying Event” such as losing employer or credible coverage, moving to a new service area, marriage, having a baby, etc.

This year many health plans will not be renewed and over 200,000 Coloradans will lose their plans…WHY?

  • The CO Division of Insurance declared that “grandmothered” plans or plans purchased from March 2010 – December 31st, 2013 will terminate this year.
  • The ACA’s new requirements has forced carriers to update their plans to meet the new plan criteria.
  • Colorado HealthOP is not able to sell plans in 2016 so if you own a HealthOP plan you must shop for a replacement.

Many carriers have changed their networks, added new networks and modified their formulary plans (drug plans), so be sure to check if your docs and meds are covered in a plan before you purchase!

The Penalty is increasing in 2016 for not owning a Credible Health Plan.

You cannot exceed 90 days without coverage and the 2016 penalty is either $695/person or 2.5% of your income, whichever is higher.

If you are a business

There are no Open Enrollment mandates so you can purchase a plan for your company at any time.

If your business will exceed 50 Full Time Equivalent Employees in 2016, you must offer a credible, affordable plan to your “eligible” employees. Eligible employees could be a different total than Full Time Equivalent employees.


There are many choices and strategies to minimize impacts.

For more information on the mandates, plan quotes, ACA information, I’m happy to help!

Neal Gold


Group Insurance • Individual & Family • Life Insurance • Disability • Medicare Plans
Health Reform Guidance & Information/Health Plan Reviews

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