2024 Pay or Play Affordability Percentage

ACA Special Enrollment Period Extended to August

On March 23, 2021, President Joe Biden and his administration reported that the Centers for Medicare & Medicaid Services (CMS) announced that it is extending the Special Enrollment Period (SEP) — which was originally available through May 15, 2021 —for an additional three months, allowing eligible individuals to enroll in Exchange coverage through August 15, 2021.

Now through August 15th, this SEP is available to all Exchange-eligible consumers who are submitting a new application or updating an existing application. Consumers can find out if they are eligible to enroll in this SEP by visiting www.HealthCare.gov, and are no longer limited to calling the Marketplace call center to access the SEP. Once an application is submitted, consumers will have 30 days to choose a plan that best fits their needs.

  • Consumers who are eligible and enroll under this SEP will be able to select a plan with coverage that starts prospectively the first of the month after plan selection.
  • Current enrollees will be able to change to any available plan in their area without restriction to the same level of coverage as their current plan.

“Through this Special Enrollment Period, the Biden Administration is giving the American people the chance they need to find an affordable healthcare plan that works for them. The American Rescue Plan will bring costs down for millions of Americans, and I encourage consumers to visit HealthCare.gov and sign up for a plan before August 15th.” — Xavier Becerra, HHS Secretary  

American Rescue Plan Act Subsidies

This extended access comes shortly after increased Affordable Care Act (ACA) subsidies were included as part of the American Rescue Plan Act (ARPA), which temporarily increases the dollar amount and expands eligibility for federal subsidies for health insurance coverage purchased through the Marketplace. In conjunction with the ARPA, the Biden administration’s action to extend the SEP is intended to increase access to healthcare through the Marketplace.

While the SEP is currently open, additional savings and lower costs will be available for consumers through www.HealthCare.gov starting April 1, 2021. These savings will decrease premiums for several people. On average, one out of four enrollees on www.HealthCare.gov will be able to upgrade to a higher plan category that offers more affordable out-of-pocket costs at the same or lower premium compared to what they’re currently paying today.

The SEP is currently available to consumers in the 36 states that use the www.HealthCare.gov platform. We recommend consumers that use their own platform and are served by State-based Marketplaces to check their state’s website for valuable information on SEPs in their state.

For additional information, click here.

The Creative Benefits team is here to assist and keep you updated on pertinent healthcare information. Questions? Contact us at 866-306-0200 or solutions@creativebenefitsinc.com.