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Old 12-19-2017, 01:42 PM
Locrian Locrian is offline
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Default Qualifying Life Events

Sorry to create a thread with such a small question, but it's the kind of question you double check with the experts.

If you choose to not enroll in your employer's annual open enrollment and lose coverage, that's a HIPAA qualifying event and you can then purchase on the exchange?

Making sure there's not a catch.
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Old 12-19-2017, 01:56 PM
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Actually I'm not sure what I wrote above is true at all. Refusing coverage is not the same as "losing" coverage.

So if your employer offers coverage outside of the ACA enrollment period and you think it's terrible coverage (which the 10% income rule, plus minimum actuarial value are meant to protect against, plus the tax exclusion should help with too), you're just out of luck, I think.
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Old 12-19-2017, 02:21 PM
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If you choose to not enroll in your employer's annual open enrollment and lose coverage
Huh?

You mean losing the coverage because you didn't enroll?
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Old 12-19-2017, 02:26 PM
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I have a family member who believes they would get a better deal in the exchange than with their employer's coverage.

I don't believe them, but I suppose it isn't impossible.

So if this family member were to NOT re-enroll in the employer health plan at the next annual enrollment, would that trigger an event so they could enroll in the exchange?
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Old 12-19-2017, 04:11 PM
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I have a family member who believes they would get a better deal in the exchange than with their employer's coverage.

I don't believe them, but I suppose it isn't impossible.

So if this family member were to NOT re-enroll in the employer health plan at the next annual enrollment, would that trigger an event so they could enroll in the exchange?
Are they included subsidies in their analysis? If they have affordable coverage from their employer, they are not eligible for subsidies. The family glitch that falls out from this has caught many people off guard as well.
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Old 12-19-2017, 04:13 PM
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I have a family member who believes they would get a better deal in the exchange than with their employer's coverage.

I don't believe them, but I suppose it isn't impossible.

So if this family member were to NOT re-enroll in the employer health plan at the next annual enrollment, would that trigger an event so they could enroll in the exchange?
They need to enroll during open enrollment.

If they get a better deal on a like plan in the exchange I will eat my hat.
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Old 12-19-2017, 04:15 PM
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I have a family member who believes they would get a better deal in the exchange than with their employer's coverage.

I don't believe them, but I suppose it isn't impossible.

So if this family member were to NOT re-enroll in the employer health plan at the next annual enrollment, would that trigger an event so they could enroll in the exchange?
No, that's not a qualifying event.
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Old 12-19-2017, 04:27 PM
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No, that's not a qualifying event.
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Originally Posted by mathmajor View Post
They need to enroll during open enrollment.

If they get a better deal on a like plan in the exchange I will eat my hat.
I don't know a lot about exchange pricing, but I think you are right - employer subsidy may not be great, but better than no subsidy, given the anti-selection risk that has to be baked in to exchange premium rates.

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Are they included subsidies in their analysis? If they have affordable coverage from their employer, they are not eligible for subsidies. The family glitch that falls out from this has caught many people off guard as well.
I just find it unlikely that they could THINK exchange a better deal unless they are doing this wrong.
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Old 12-19-2017, 05:28 PM
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I just find it unlikely that they could THINK exchange a better deal unless they are doing this wrong.
I am with you there. I want more details from the OP.
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Old 12-19-2017, 06:52 PM
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I just find it unlikely that they could THINK exchange a better deal unless they are doing this wrong.
Really?

It surprises anyone here that a relative could have a crazy idea about the ACA exchanges?

I listed three very good reasons why employer coverage should be superior above.

But sometimes people are going to do crazy stuff, so I'm trying to at least ensure they don't do something catastrophic.
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