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Determine if You Need to Change Plans

If you buy your own health insurance and don’t have a grandfathered plan (one that’s been in effect since before March 23, 2010), you’ll eventually have to buy a new ACA plan.

The new ACA plans go into effect on January 1, 2014. But when you have to purchase depends on when your current plan expires:

  • If it expires in 2014, you can:
    • Replace it with an ACA plan with an effective date that begins on the date your current plan expires, or
    • Replace your current plan as early as January 1, 2014 if you qualify for Subsidies that may make an ACA plan more affordable than your current plan, or
    • Cancel your current policy in November of 2013, and renew it in December of 2013 to keep your current plan for an additional 12 months, as you’re allowed by law.

    A few things to keep in mind, if you want to renew by November:

    • Your deductible and any out of pocket maximums will reset on December 1, 2013 when your new policy is issued. So, if you have accumulated any amount toward meeting your current deductible or an out of pocket maximum during 2013, you will lose it and start over on December 1. You need to understand that your new plan will reset again on January 1, 2014 for the deductible and out of pocket maximum because your plan operates on a calendar year basis.
    • Before December 1, 2014 you must choose a new ACA-compliant plan that will be in effect for only one month (December 2014) and the deductible and out-of-pocket maximum for the new plan will reset as of that date. You will also receive a rate increase at that time to reflect the cost of your ACA-compliant plan. You cannot get another 12-month plan at that time because ACA requires that all individuals purchasing health insurance to have a uniform effective date of
      January 1.
    • On January 1, 2015, you must begin yet another new plan year in your ACA compliant plan. At that time, your deductible and out of pocket maximum will reset for the 2015 calendar year, and you may receive a rate increase depending upon on the plan you choose. This new plan will be in effect until December 31, 2015, and would renew on a calendar year basis after that.
    • No claim forms to fill out for in-network and out-of-network services when rendered by participating providers.

    All of the points above conform to federal and state requirements.

    Please consider the impacts of the multiple deductible and out-of-pocket maximum resets, re-enrollments and premium increases that you will experience.