CMS Expands HealthCare.gov 2022 Open Enrollment Period & Under-65 Health Options

To improve health coverage access for more Americans, the Centers for Medicare & Medicaid Services (CMS) are expanding the Open Enrollment Period (OEP) for Affordable Care Act (ACA) coverage, among other measures to decrease health disparities nationwide.

We’ll explain what these changes are so you can best prepare to properly utilize this information for a successful sales season!

Extension of the 2022 Open Enrollment Period on HealthCare.gov

The White House and CMS are extending the (non-Medicare) OEP for under-65 health enrollments on HealthCare.gov by 30 days. The under-65 health OEP will now take place from November 1, 2021, through January 15, 2022, on the government site. (The OEP was originally set to end on December 15, 2021, as in years past.) This gives your clients more time to connect with you, so you can secure their necessary insurance needs and sign them up for coverage going into the new year.

Please note: State marketplaces with their own eligibility and enrollment platforms may set their own annual Open Enrollment Period end dates, so long as these dates are on or after December 15, 2021.

A New Special Enrollment Period for Low-Income Individuals

In addition to the OEP extension, there will also be a new monthly Special Enrollment Period (SEP) “targeting certain low-income individuals in Marketplaces through HealthCare.gov.” and “[providing] the vast majority of eligible consumers with one or more options to enroll in free or very low-cost plans thanks to provisions in the American Rescue Plan.” This extra enrollment option will allow for even more enrollments past the extended OEP deadline.

In addition to the OEP extension, there will also be a new monthly Special Enrollment Period (SEP) “targeting certain low-income individuals in Marketplaces through HealthCare.gov.”

Expansion of Federally-Facilitated Marketplace Navigators

Beneficiaries will also have easier access to knowledgeable professionals and resources who can help them better navigate their rights, care, and insurance needs, thanks to CMS expanding the navigator program. There will now be four times as many navigators available (1,500 total) to assist shoppers, and navigators will be able to discuss post-enrollment topics such as the appeals process and premium tax credit reconciliation.

Navigators typically assist those in disparaged and underprivileged communities, helping more people better understand the coverage they’re entitled to and how to best access and utilize that care. However, navigators can’t sell plans or recommend one over another. Insurance agents like you can play a vital role in closing that knowledge and need gap while earning more commissions!

Navigators can’t sell plans or recommend one over another. Insurance agents like you can play a vital role in closing that knowledge and need gap while earning more commissions!

The Relaunch of the “Champions for Coverage” Program

Lastly, CMS is relaunching “Champions for Coverage” — a program comprised of over “1000 local organizations that are active in providing outreach and education about the Health Insurance Marketplace and how consumers can enroll in coverage through HealthCare.gov, Medicaid, or the Children’s Health Insurance Program (CHIP).”

The White House is encouraging more local organizations to become Champions for Coverage by signing up on the Health Insurance Marketplace website to spread the word about Open Enrollment and the exciting new changes and expansions coming for 2022.

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You can read CMS’ full press release here. These changes should not raise marketplace issuer user fee rates above those from 2021, and therefore should keep premiums low for beneficiaries. We can likely expect more information to be announced as the beginning of OEP draws closer, so we recommend keeping an eye out for any future updates!

Have further questions or want to learn more about how you can sell under-65 plans during the upcoming OEP? Please contact a Ritter sales specialist!

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