when can I purchase health insurance?

Open Enrollment Period

Open Enrollment is the period of time during a year when a business, Medicare eligible, or individual is  permitted to purchase, change, or terminate insurance coverage.

For businesses, open enrollment refers to the time when employees are able to make additions, changes, or waive their employer’s offered coverages. Fully insured carriers usually permit employers to make employee changes to elections 30 days prior to the group’s renewal date. The open enrollment window of the carrier can be flexible if there is a business reason for a different time period, such as a calendar year plan, a different fiscal year, or if the group makes major plan changes. However, we do recommend requesting prior approval. Small groups that do not meet participation can purchase ACA plans for a January 1 effective date as long as their application is received by the official Open Enrollment Period deadline (typically November 15 to December 15 each year).

Individuals and families can enroll in plans from November 1 to December 15 each year with starting dates of January 1 the next year.

Medicare eligible can enroll in a plan between October 15 and December 7 (the early shopping period begins October 1). Plans start January 1.

Special Enrollment Period (SEP)

Special Enrollment Period (SEP) is a time outside of Open Enrollment when you can sign up for health insurance. Usually, you qualify for SEP due to certain qualifying events such as:

  • Marriage
  • Divorce
  • Legal separation
  • Birth
  • Adoption
  • Death
  • Termination of employment for the employee or their spouse or dependent
  • Reduction or increase in hours worked that changes eligibility for the plan
  • A significant change in spouse’s employer’s coverage
  • Movement out of area
  • Dependent no longer eligible
  • The purchase of individual or Medicare coverage

Any changes made must be consistent with the type of life change. For example, the birth of a child would involve adding a child to coverage, but not terminating coverage of a spouse.

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ARC Benefit Solutions, Inc. is a wholly-owned subsidiary of CBISA Holdings, Inc., which is licensed as an insurance agency in all states in which it sells. Not all agents are licensed to sell all products. Service and product availability vary by state. Sales agents may be compensated based on a consumer’s enrollment in a health plan. Not connected with or endorsed by the U.S. Government or the federal Medicare program. The purpose of this communication is the solicitation of insurance. Contact will be made by an insurance agent or insurance company. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. ARC Benefit Solutions currently represents 15 organizations and more than 16,000 total possible plan options, depending upon your county of residence. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options. This site contains decision-support content and information about Medicare, services related to Medicare, and services for people with Medicare. If you would like to find more information about the Medicare program please visit the Official U.S. Government Site for People with Medicare located at http://www.medicare.gov.