Open Enrollment 2025

Open Enrollment is the time period each year when individuals and families can enroll in health coverage or make changes to their existing coverage. If an individual is enrolling in an ACA-compliant Marketplace plan, this period is from November 1 through January 31 (with some exceptions). If an individual is enrolling in employer-sponsored benefits, the timeline may vary, but the period typically occurs in the fall for coverage the following year.

If you want coverage by January 1, 2025, you’ll want to enroll by December 15, 2024. There may be some wiggle room on this depending on the state you live in, but not if you can enroll through Healthcare.gov.

What if I miss open enrollment?

If you miss open enrollment, there are limited options for when you can enroll in a marketplace plan. You may be eligible for a Special Enrollment Period (SEP) if you have experienced one of these qualifying events

·     Marriage

·     Divorce

·     Citizenship status

·     Adoption

·     Loss of coverage

In order to qualify for a SEP, you must have had MEC coverage before the qualifying life event.

Can I just get health coverage now?

If want to find healthcare coverage right now, or sign up on your own schedule, you can shop directly for an individual plan—by contacting the company yourself. If you run your own business or are self-employed, a third-party administrator may be able to help you find or build a plan that meets your specific needs. Third-party administrators have a lot of flexibility and can help you sign up anytime.

Penalties

There is no longer a federally imposed individual penalty for not enrolling in a health plan. However, there are some states that will still penalize residents without minimum essential healthcare coverage. These states include California, Massachusetts, New Jersey, Rhode Island, Vermont, and District of Columbia. Each state has its own criteria, so if you live in one of these states, make sure you research how penalties are assessed.

There is a federally imposed penalty for businesses that fail to offer minimum essential coverage to their employees. For businesses that offer nothing, the annual penalty will be $2,900 (2025) per employee (minus the first 30). This penalty can really add up for small to mid-size businesses (those with 50 or more employees). And it can be avoided by offering a benefits package that includes an MEC plan. 

Enrolling in group benefits

Though the open enrollment period for individuals is in the fall, a business may enroll in group benefits at any time. If your business does not currently offer health benefits to your employees, now is an excellent time to consider enrolling your business so you can offer a health plan in time for Open Enrollment.

Why enroll in group benefits

There are many reasons to consider enrolling in group benefits. Besides saving money by avoiding penalties, offering a benefits package can help you keep your employees happy and even attract top talent. This is why Planstin has focused on solutions for businesses of all sizes.

Qualifying for a group health plan

If you are looking for affordable employee benefits to meet the federal requirements and avoid penalties, your best bet is to find a qualifying minimum essential coverage plan, or MEC plan. This kind of health plan will allow you to offer health coverage to your employees for things like preventive care and pre-existing conditions.

Qualifying for a group health plan should be relatively easy. Planstin Benefit Guides are happy to help you discuss your options and find a plan that will fit your budget. Let us help you pick a plan, avoid penalties, and keep your employees happy.