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Small Business Employee Benefits and HR Blog

5 Things to Know About the 2015 Health Insurance Marketplaces

With the holidays approaching, the season of window shopping has begun. And gifts aren’t the only thing consumers will be looking for over the next few weeks - consumers will start window shopping for health insurance, too. This week, HealthCare.gov drew the curtains to allow consumers a look at what’s being offered in the Health Insurance Marketplaces. So what’s new with the Marketplaces this year? Here are five things to know.5 Things to Know about the Health Insurance Marketplaces in 2015

1. Enrollment Expected to Grow to 13 Million

In 2014, over seven million people bought health insurance plans through the Marketplaces, and the percentage of uninsured Americans is at the lowest it has ever been - 13.4% in Q2 of 2014. 

What is expected for 2015? The Congressional Budget Office has estimated that enrollment will grow to 13 million. More individuals are purchasing individual health insurance coverage than ever before.

2. Individual Mandate Penalty Goes Up

But what about those that still decide not to get health coverage? For 2014, individuals that didn’t have coverage will either have to pay 1% of their yearly household income or $95 per person for the year ($47.50 per child under 18) - which ever amount is greater.

Does this apply to 2015 as well? Yes, and the Individual Shared Responsibility Fee increases in 2015. Individuals who do not have coverage in 2015, and do not qualify for an exemption, will have to pay the greater of:

  • 2% of yearly household income, or
  • $325 per person for the year ($162.50 per child under 18)

With the fee increasing in 2015, most will find it less expensive to purchase affordable coverage than it is to pay the fee.

3. Auto-enrollment

If you already have coverage and don’t want to go through the full application process again this year, there is an auto-enrollment option available. This new option makes re-enrollment easy for the consumer, and it is also going to help free up website traffic during open enrollment.

That being said, some people who choose auto-enrollment may be surprised with premium changes. To avoid surprise premium increases, contact the Marketplace to update them about any changes in personal, household, or financial details, and shop around to see if any of the new plans available are better suited to your financial or healthcare needs.

4. Premium Tax Credits Available

For those with moderate incomes (individuals and families whose yearly household income is between 100% and 400% of the federal poverty line) premium tax credits are available.

The premium tax credits significantly reduce the cost of health insurance for most Americans. In 2014, 87% of those who selected a health plan received premium tax credits and paid, on average, only $82/month.

5. Expect a Few Glitches

Lastly, even though many of the HealthCare.gov glitches have been fixed, experts warn that this year’s enrollment period won’t be glitch-free. The good news is there are measures that have been taken to ensure that the 2015 Health Insurance Marketplaces will be run more smoothly. And, whatever the outcome is when open enrollment begins in a few days, the expected glitches and hiccups should be nowhere near those of 2014. 

Conclusion

These five things will help to know what to expect over the next few weeks as consumers begin to shop for or renew their Marketplace health plans. What are you watching for as the Health Insurance Marketplaces open next week? Let us know in the comments below.