Is It The Ole Bait and Switch or a “Minor” Over-looked Detail?

From day one when we were introduced to the Patient Protection and Affordable Care Act (PPACA, ACA, or “ObamaCare”) back in 2010, we were told that everyone was required to have insurance by 2014 or face a penalty of some sort.  And of course, no one really knew, let alone understood, what was in the 2000+ page law.  We were told by our illustrious Congress (yep, the same one that closed the government down for 16 days this month cause they wouldn’t play nicely in the sandbox), that they had to pass the law before we would find out what was in it.  I’m not the only one that thinks that’s just a wee bit backwards.  Anyway, I’m off track here.

As the years came and went, bits and pieces of information on deadlines and requirements were handed out to the public and the healthcare industry.  We now find ourselves on the eve of calendar year 2014 when the biggest part of the ACA will come into effect…..the mandatory requirement of having government qualified health insurance.   (Queue the music – dun…..dun.…..dun…dun….).  Yeah, and there is that bit about the part where you can only purchase your health insurance during the open enrollment period (unless you face a life changing circumstance like marriage, divorce, babies, adoption, etc.).  Open enrollment for this initial year has always been advertised (in multiple formats) as October 1, 2013 to March 31, 2014.  Six whole months to check out the new Health Insurance Marketplace, find out what your premium tax subsidy will be, and find out what plans you and your family are qualified for!  Awesome deal!  You don’t have to rush into your decision!  It’s not like buying a car where you feel pressured right then and there to make a decision.  It’s more like shopping for that perfect pair of shoes….well, sort of.

This is where I burst your bubble as you are envisioning yourself skipping through the mall looking for the right shoes, I mean, insurance plan for your family.  There is this little caveat in the ACA that states “you can’t go more than three months without a qualified health insurance plan, or you will be penalized”, hence the deadline of March 31, 2014.  That’s 3 months past January 1, 2014.  The tax penalty isn’t necessarily just for someone who doesn’t have any health insurance in 2014 but it’s also for those who don’t have insurance for more than 3 consecutive months.  Ok, so you are thinking “I still have 6 months to buy my insurance.  I’ll be ok as long as I buy it by March 31.”  Well….here is my bubble bursting moment again.  You need a minimum of 15 days to get your insurance in place.  IF you purchase your insurance by February 14, you will be covered by March 1.  If you purchase your plan between February 15 and 28, your insurance plan will take affect 6 weeks later, at the beginning of the FOLLOWING month…that would be April 1.  No, this is not an April Fool’s joke.  At least it’s not on my part….can’t vouch for anyone else.

Now with all the issues and troubles the Department of Health and Human Services (Dept. HHS) has had in rolling out the Marketplace they are talking in Congress to extend the enrollment period to March 31, 2014.  But you are thinking “enrollment is already til March 31.”  Yes, open enrollment is til this date BUT they would be allowing you to purchase your qualified insurance plan up to and including March 31…which would actually make it active on May 1, 2014.  See the difference here?  Originally, just because you purchased your insurance by March 31 didn’t mean you actually met the deadline to not be charged a penalty.  But that was never made clear.  Clear as mud isn’t it?

We here at KSS Insurance are doing our best to keep this whole insurance thing as simple as possible for you to understand.  Healthcare under the ACA is not like your grandpa’s insurance.  It’s a whole new world for everyone even remotely associated with the healthcare industry…not just those that actually need health insurance.  So, check back often to see what new information we can share. Go to our website at  We are here to keep it simple…for you.

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