California: OE6 to run 3 months & kick off on...October 15th??

2018 MIDTERM ELECTION

Time: D H M S

OK, this is just kind of...odd.

As regular readers will recall, after three years of full 3 month Open Enrollment Periods across every state, last year the Trump Administration slashed the official Open Enrollment Period in half, down to just 6 weeks, from November 1 - January 31 down to November 1 - December 15th.

In response, most of the state-based exchanges announced that they were sticking with a longer period anyway, ranging anywhere from a 7th week all the way out to the full 3 month period, in the case of California, New York and the District of Columbia...each of which kept things going all the way through January 31st as had become the norm.

California even went one step further, passing a state law specifically mandating a 3-month Open Enrollment Period for 2018 and beyond.

Until today, I've been operating on the assumption that they'd be sticking with the November/December/January schedule which had become the default.

Apparently not, however. According to Louise Norris:

Open enrollment for 2019 coverage will begin October 15, 2018 in California, and continue until January 15, 2019

Nationwide, open enrollment for 2019 coverage is scheduled to run from November 1, 2018 to December 15, 2018 — the same schedule that was followed in late 2017 for 2018 coverage. But Covered California was one of only three state-run exchanges that opted in 2017 to keep open enrollment at three months in duration for 2018 coverage (the others were New York and DC).

And the state enacted legislation (A.B.156) in late 2017 that codifies a three-month open enrollment period going forward — California will not be switching to the November 1 – December 15 open enrollment window that other states will be using.

Instead, California’s open enrollment period will begin October 15, and will continue until January 15. On-exchange, the November 1 – December 15 open enrollment period will be supplemented by a special enrollment period from October 15 to October 31, and another special enrollment period from December 16 to January 15 (these special enrollment periods are necessary because federal regulations designate November 1 to December 15 as the official open enrollment period, so California had to supplement that with special enrollment periods, rather than changing the official dates of open enrollment).

Coverage purchased between October 15 and December 15 will be effective January 1 of the coming year, while coverage purchased between December 16 and January 15 will be effective no later than February 1.

Off-exchange, open enrollment will also run from October 15 to January 15.

Sure enough, the actual text of the bill she refers to states:

...Existing law requires a plan and health insurer to provide an annual enrollment period for policy years beginning on or after January 1, 2016, from November 1, of the preceding calendar year, to January 31 of the benefit year, inclusive. Existing law requires a plan and health insurer, annually on or before October 1, to issue a notice to a subscriber and policyholder, as applicable, enrolled in any individual health benefit plan offered outside of the Exchange, and requires this notice to inform the subscriber and policyholder of, among other things, the applicable open enrollment period provided through the Exchange.

This bill would instead require, with respect to individual health benefit plans offered outside of the Exchange, that the annual open enrollment period for policy years beginning on or after January 1, 2019, extend from October 15 of the preceding calendar year, to January 15 of the benefit year, inclusive. The bill would instead require, with respect to individual health benefit plans offered through the Exchange, that the annual open enrollment period for policy years beginning on or after January 1, 2019, extend from November 1 to December 15 of the preceding calendar year, inclusive. The bill would require a health care service plan and a health insurer, with respect to individual health benefit plans offered through the Exchange, for policy years beginning on or after January 1, 2019, to provide a special enrollment period that will allow individuals to enroll in individual health benefit plans through the Exchange from October 15 to October 31 of the preceding calendar year, inclusive, and from December 16, of the preceding calendar year, to January 15 of the benefit year, inclusive, and would require an application for a health benefit plan submitted during this special enrollment period to be treated the same as an application submitted during the annual open enrollment period. The bill would require a plan and health insurer to also include in the annual notice described above information regarding the applicable special enrollment periods. The bill would make conforming changes.

Why are they starting and ending California's Open Enrollment Period 16 days earlier? The only reason which I can think of that makes sense is that this would ensure that every enrollee has their policy effectuation start no later than February 1st. If they keep it going through 1/31, that means anyone who enrolls in the final two weeks wouldn't have their policy kick in until March 1st.

Insurance carriers would ideally prefer to have everyone's policy go into effect starting on January 1st, of course; that makes it much easier for actuaries to crunch their numbers. And of course it's better for the enrollee to have a full 12 months to utilize their coverage, especially since the deductible resets every calendar year. So locking in the February effectuation date may simply be a way of splitting the difference: Not everyone will start on 1/01, but there won't be stragglers starting on 3/01 either.

In any event, this does mean that the marketing/outreach is going to be a bit confusing this fall...not so much for the end date (again, for OE5 the end dates were already all over the calendar), but for the start date. 12% of the country will be told "OPEN ENROLLMENT STARTS 10/15!" while the rest will be told it starts on November 1st.

There's one other potential bit of fallout from this news: Remember, the midterm election is on November 6th. Open Enrollment will start in 49 states (+DC) 5 days earlier; in California it will be 22 days earlier. Depending on what happens with 2019 ACA policy premiums, that could have some impact.

UPDATE: Several people have pointed out that Medicare's Open Enrollment program starts on October 15th, so it might be a simple matter of lining up the start times to avoid confusion on that front.