Oregonians now have an additional month to apply for private health insurance. New deadline to apply is April 30. The Oregon Insurance Division and Cover Oregon urge people to apply now to get coverage as soon as possible and avoid potential end-of-month rush. 

 


Frequently Asked Questions: Oregon’s extended application period

What is Oregon’s extended application period?

Oregon opened an extended application period that allows Oregonians to apply for private individual health insurance through Cover Oregon and directly with insurance companies through April 30, 2014.  This means that applications need to be postmarked by Wednesday, April 30.

Is this just for people who want to apply through Cover Oregon?

No, this applies to any individual who wants to buy health insurance in 2014, including those who want to buy coverage directly from an insurance company.

April 30 is the deadline to apply. What is the deadline to enroll?

We recommend that people enroll as soon as they can after they receive their approval from Cover Oregon. We will continue to process the applications we receive in April throughout May. We will let all outstanding applicants know directly when they have to complete their enrollment by to get coverage in 2014.

Does this mean that people have another month to apply through Cover Oregon to avoid the federal tax penalty?

If people apply through Cover Oregon by April 30, 2014 and then enroll in a Cover Oregon plan, they will be exempt from a potential federal tax penalty. People who apply and enroll in plans outside of Cover Oregon between April 1 and April 30 may have to pay a partial federal penalty. The Oregon Insurance Division will provide more information about how penalties may apply to individuals who do not apply for coverage through Cover Oregon as soon as possible.

What if people do not apply by April 30?

If you do not apply by April 30, you will have to wait until the next open enrollment period and you could be subject to a potential federal tax penalty. The start of the next open enrollment period is Nov. 15, 2014, and the soonest coverage could start is January 1, 2015.  Those eligible for the Oregon Health Plan (OHP) can enroll year round, though they may be subject to the federal tax penalty for not having health insurance if they don't apply by April 30. If you experience certain qualifying events, such as becoming a parent or a change in your marital status, you may be able to apply and enroll in a private plan later in 2014.

How does this differ from the federal extension that was announced?

The federal announcement was for states that use healthcare.gov. States with state-based marketplaces, like Oregon, are able to take their own approaches to reflect their unique markets and circumstances.

I have been waiting to hear from Cover Oregon because I already submitted an application. Will my application get processed in time for me to avoid a potential federal tax penalty?

If you have already submitted your application and you enroll in coverage through Cover Oregon, you will not be subject to a potential federal tax penalty.

I enrolled in a plan directly with an insurance company before April 1.  Will I have to pay a federal penalty?

No. If you enrolled in a plan directly with an insurance company on or before March 31, you will not be subject to a potential federal tax penalty.  If you wait to buy coverage directly from an insurance company between April 1 and April 30, you may have to pay a partial federal tax penalty. The Oregon Insurance Division will provide more information about how penalties may apply to individuals who do not apply through Cover Oregon as soon as possible.

I have filled out an application and am eligible for a private plan, but have not yet selected a plan. What’s the last day to enroll?

Once people have applied by April 30 and then qualified for private coverage through Cover Oregon, they will have a reasonable period of time to enroll. The final enrollment date has not yet been set. We are urging people not to wait. If you have been qualified, choose your plan and get enrolled so you can avoid the last-minute rush.

The only exception is if you experience certain qualifying events, such as becoming a parent a change in your marital status, in which case you may be able to enroll in a private plan later in 2014.

What is the difference between applying and enrolling?

Applying is what you do to find out what plans you are eligible for and whether you can qualify for financial assistance. The application is where you submit to Cover Oregon information about your family size, income and where you live. You have to apply by April 30 for 2014 coverage.

Enrolling is what you do after you have heard back from Cover Oregon. It means you’ve been notified what you are eligible for and you choose which insurance plan you want. Please note that if you are eligible for the Oregon Health Plan, you will be automatically be enrolled and don’t have to take further action.

Certified Cover Oregon agents and community partners can help you apply and enroll online and in one sitting. Find a certified agent or community partner at CoverOregon.com.

What are the qualifying events that allow people to apply for or change coverage outside of open enrollment? 

Marriage, divorce, adding children to your family, changing income, etc. Here is a full list.

Is the extended application period for both private insurance and the Oregon Health Plan?

Yes. After April 30, people who want to purchase private health insurance have to wait until the next open enrollment period, which starts November 15, 2014 with coverage effective January 1, 2015. Those eligible for the Oregon Health Plan (OHP) can enroll year round, though they may be subject to the federal tax penalty if they don't apply by April 30.

How does this affect the Oregon Health Plan?

Those eligible for the Oregon Health Plan (OHP) can enroll year round, though they may be subject to the federal tax penalty for not having health insurance if they don't apply by April 30. Coverage generally begins the day the application is received, so there is no lag time.

How can consumers be sure that they won’t get a penalty?

Oregon has the authority to call an extended application period and the federal government has agreed not to assess any potential penalties for Oregonians who apply for coverage through Cover Oregon by April 30, 2014.  If you wait to buy coverage directly from an insurance company between April 1 and April 30, you may have to pay a partial federal tax penalty. The Oregon Insurance Division will provide more information about how penalties may apply to individuals who do not apply for coverage through Cover Oregon as soon as possible.

How will the exemption from the federal tax penalty work for people who applied in April?

We are working out the details with the federal government on that and will have more specific guidelines soon.  Be assured that Oregonians who apply by April 30, 2014 and enroll in a plan through Cover Oregon will not be subject to a potential federal tax penalty. If you wait to buy coverage directly from an insurance company between April 1 and April 30, you may have to pay a partial federal tax penalty. The Oregon Insurance Division will provide more information about how penalties may apply to individuals who do not apply for coverage through Cover Oregon as soon as possible.

How much is the federal penalty? Are there any exemptions?

The federal tax penalty for not having health insurance in 2014 is either 1 percent of your family household income, or a maximum $95 per person ($47.50 per child under 18), whichever is greater (note: penalty is calculated on number of months uninsured and is prorated). The penalty amount increases every year until 2016 when it reaches $695/per adult, or 2.5 percent of income. From then it will be adjusted by inflation (there is an overall cap each year). In essence, the options for each month are (1) get insurance, (2) claim an exemption or (3) pay the penalty. There are hardship exemptions for the penalty and those can be found here.