Now that 2020 is here, the next Affordable Care Act (ACA) annual Open Enrollment period will begin November 1, 2020 and run through December 15, 2020. Please note that some states have more expansive open enrollment periods: https://www.healthinsurance.org/faqs/what-are-the-deadlines-for-obamacares-open-enrollment-period/. In addition, you may be eligible for a special enrollment period if you experience a qualifying life event.
A qualifying life event that would make you eligible for special enrollment period includes a loss of coverage, a change in your household or a change in your address. For a complete list of qualifying live events, visit: https://www.healthcare.gov/glossary/qualifying-life-event/
As noted in previous updates, beginning January 1, 2020, employees will be able to use employer-funded Individual Coverage HRAs (ICHRAs) to buy individual-market insurance, including insurance purchased on the public exchanges. For more information about ICHRAs, please go to: https://www.healthcare.gov/ichra/ For more information about health savings accounts, please read: https://theaiatrust.com/filecabinet/HSA-Fact-Sheet.pdf
Unfortunately, most of the news regarding new health insurance products for association members has been related to court rulings. The Affordable Care Act (ACA) essentially provides two options to obtain private health insurance: as an individual via the exchanges or as an employee through your employer. In 2018, the Department of Labor issued regulations that expanded the eligibility for Association Health Plans (AHPs) to include sole proprietors; however, in March of 2019 a federal judge ruled that major provisions of the new regulations were unlawful. That decision is under appeal at this time.
Regarding the ACA, another federal judge ruled in December of 2018 that since Congress eliminated the individual mandate penalty, the ACA is no longer constitutional under Congress’ taxation power. On appeal, the 5th circuit ruled that it was unconstitutional for the ACA to require individuals to purchase health insurance and returned the case to the district court for further review. Currently the Supreme Court is weighing whether to expedite the appeals process, but as of this writing, no decision has been made and the ACA remains in effect.
Currently, there are no healthcare plans with association group pricing that would include the many sole proprietors and small firms that comprise AIA membership. The AIA Trust continues to monitor healthcare insurance reform to identify any potential future healthcare coverage options and will continue to publish quarterly healthcare updates.
The AIA Trust has compiled a list of resources about how requirements may impact your healthcare coverage and your firm: https://www.theaiatrust.com/healthcare-coverage/