CT Insurance Exchange Plans to Be Strict With Enrollment Exceptions

Access Health CT’s enrollment period has come to a close. Individuals participating in the health insurance exchange were advised to select a policy by January 31st.
Yet, Connecticut, like many states, makes exceptions for certain instances. But, according to a piece in the CT Mirror, the amount of exceptions is financially straining insurance companies. In response, the state plans to set forth stricter standards for what can be used as an exception.
For those not familiar, individuals participating in the state insurance exchange can only enroll during certain points of the year. However, because lifestyles change and incidents happen, states have a handful of scenarios qualifying for exceptions, including divorce, losing a job, or having a sharp change in income. Along with these, other situations include:
Marriage to a person with a plan through the state exchange.

  • Having or adopting a child, who then needs coverage.
  • Moving to Connecticut from another state.
  • Finding yourself eligible for the state insurance exchange, such as experiencing a change in income or getting dropped from an employer-sponsored plan.
  • No longer having health care through a job, spouse, COBRA, or Medicaid.

Should one of these changes occur, an individual has up to 60 days to take out a policy through Access Health CT.
Connecticut, on the other hand, has taken a more lenient approach. So far, Access Health CT has not required individuals to prove they need an exception, but rather has used “self-attestation.”
This approach has resulted in a burden placed on insurance companies. According to a survey from Wakely Consulting Group, individuals who signed up outside the standard enrollment period dropped coverage sooner and had higher healthcare expenses. It’s estimated that thousands per month request exceptions, but 15,000 then drop their policy over the course of the year.
As a result, Connecticut now plans to require proof for an exception.
Interested in learning more about the state insurance exchange, policies, and eligibility? Give Ion Insurance a call today at 203.439.2815.