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Procedural question on ACA
Old 10-09-2013, 02:07 PM   #1
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Procedural question on ACA

Procedural question for those who may be a little more knowledgeable about the ACA. If you have employer provided insurance right now but plan to retire in January, must you wait until you have actually retired and left the job before you apply for insurance in the marketplace? I plan on retiring in mid-January, with coverage through Jan 31st. Since my coverage will end Jan 31st it seems wrong that I have to wait until it actually ends to buy insurance on the marketplace (with subsidy help). But the applications ask if you currently have coverage and I assume you can’t buy a policy (with subsidy help) if you have employer provided coverage at the time of the application.

Does anyone know how the nuts and bolts of how you do this when transitioning from employer provided health care to an ACA policy (with subsidy help). Seems like there should be a way to get everything lined up so it is in force at the appropriate time when your current insurance ends. I have an ACA application in front of me and the same question could be asked about filling out the current job and income information. If you are retiring, how do you complete this application with information for the coming retirement period, using your retirement income, when you are still employed? Any help would be appreciated.
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Old 10-09-2013, 02:22 PM   #2
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Quote:
Originally Posted by Buck2520 View Post
Procedural question for those who may be a little more knowledgeable about the ACA. If you have employer provided insurance right now but plan to retire in January, must you wait until you have actually retired and left the job before you apply for insurance in the marketplace? I plan on retiring in mid-January, with coverage through Jan 31st. Since my coverage will end Jan 31st it seems wrong that I have to wait until it actually ends to buy insurance on the marketplace (with subsidy help). But the applications ask if you currently have coverage and I assume you can’t buy a policy (with subsidy help) if you have employer provided coverage at the time of the application. Does anyone know how the nuts and bolts of how you do this when transitioning from employer provided health care to an ACA policy (with subsidy help). Seems like there should be a way to get everything lined up so it is in force at the appropriate time when your current insurance ends. I have an ACA application in front of me and the same question could be asked about filling out the current job and income information. If you are retiring, how do you complete this application with information for the coming retirement period, using your retirement income, when you are still employed? Any help would be appreciated.
In this case, you're going to be much better odd talking directly to a health insurance agent rather than trying to use the exchange. I believe you're going to have to wait until you're actually retired to qualify for coverage/subsidy but, remember, starting February 1st, you'll qualify for COBRA but won't have a premium due until March 1st. So there'll be no huge rush. Plus, any "life event" changes the standard open enrollment period (not an issue in 2014 anyway).

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Old 10-09-2013, 02:57 PM   #3
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The enrollment period for the exchange is open until 03/31, which is after you end employer coverage so you can buy then. Since this is all new , none of us have actually gone through this for real. Usually when you apply for insurance you can set a start date. Your start date would be after your current insurance ends, so at that time you would have no insurance ( that's my spin on it ). I would put you in the classification of someone who is losing job based insurance.

Here's a FAQ link that might help https://www.healthcare.gov/what-if-i...sed-insurance/
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Old 10-09-2013, 04:16 PM   #4
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Yes I know the enrollment is still open and I know that loosing work based insurance is a justified Reason to enroll outside of open enrollment. I am just trying to figure out a way to not go without insurance for even one minute of one day. Think I may have to use a broker as jfly4 suggested. Anyone know if that cost you more? I have VA coverage but need coverage for DW.
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Old 10-09-2013, 05:00 PM   #5
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Originally Posted by Buck2520 View Post

Does anyone know how the nuts and bolts of how you do this when transitioning from employer provided health care to an ACA policy (with subsidy help). Seems like there should be a way to get everything lined up so it is in force at the appropriate time when your current insurance ends. I have an ACA application in front of me and the same question could be asked about filling out the current job and income information. If you are retiring, how do you complete this application with information for the coming retirement period, using your retirement income, when you are still employed? Any help would be appreciated.
Currently, for Jan 1 coverage, you need to apply, select the policy and pay the first month by Dec 15, all based on your projected status as of Jan 1. Your case should be no different. The information you enter (employment, coverage, income) should correspond to your effective retirement / new coverage date, and there is no reason you cannot begin the process a month in advance once you have firm dates.

If you need an immediate subsidy you must use the exchange. If you are eligible for tax credits and can wait you can get the policy directly from the insurer or through an agent. Policies available on the exchange can be sold elsewhere but must charge the same premium.
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Old 10-10-2013, 11:06 AM   #6
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It doesn't cost any more to use an insurance agent. Premiums you pay are based on paying the agent a commission, whether you use an agent or deal direct with the insurer. Because of the way state insurance departments require insurors to file their rates it is not possible to create a rate for using an agent or not. Commissions are small -- less than 5% in most states.

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Old 10-10-2013, 05:19 PM   #7
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I'm in the same boat as Buck, but figured I'd cross that bridge in January... figuring that it's a life change, they'd have procedures for that. I kinda doubt that the rules would give a benefit to someone who knew they'd be out of a job at a future date versus the guy who suddenly and unexpectedly was without a job. So if the unexpected job loss guy will end up paying more, might just need to align my ducks.
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