Pay Your Premium in Order to Effectuate Your Health Insurance Policy

Pay the Premium to Effectuate Your Policy

In 2014 and 2015, it was generally acceptable to get a plan and not pay the first month’s premium for up to three months. Even though the payment was deferred, people would still have coverage for those first three months. However, carriers ended up losing a lot of money with this approach. So during last year’s open enrollment, the carriers allotted their clients 30 days to pay the first month’s premium and effectuate their policies.

A 30-day grace period, however, had some setbacks. If people didn’t pay the premium for the January 1st effective date after 30 days, then they’d lose their policy. In addition to losing their policy, they are now outside of the open enrollment period (OEP). If you miss OEP (November 1st to January 31st), then you need a special enrollment period (SEP) in order to get a qualified health plan. Unfortunately, missing your premium payment does not qualify for an SEP.

For the 2017 OEP, the carriers had clients pay the premium prior to January 1st in order to activate the policy. If you don’t, then you’d have to reapply by the next deadline and pay the first month’s premium by the effective date. The next deadline is actually around the corner – January 15th – which means the plan is effective starting February 1st.

10 or 15-day Grace Period

Since so many carriers left the marketplace this year, the remaining carriers gained a lot of new business, which is overloading their systems. As a result, the carriers have given a 10-day grace period for clients to effectuate their coverage. In some cases, it’s a 15-day grace period.

Ultimately, make sure you pay the first month’s premium before the effective date so that you don’t lose coverage. If you delay, then you have to re-enroll and pay immediately. Because if you don’t pay by January 31st and OEP ends, then you’ll be without qualified health coverage. However, there are plan options outside of the Affordable Care Act (ACA). So if you miss the payment deadline during OEP, get with an agent to discuss your available plan options.

System Overload: Payment Process Delayed

Since carriers are overloaded, their systems are not processing payments quickly. So even if you paid your premium, you may still be getting bills. Additionally, for those whose plan was non-renewed, typically auto-renews them. This year, though, they renewed people in a similar plan of similar premium. In other words, they gifted you to another carrier. As a result, the carrier, with whom you’ve been auto-renewed, bills you even if you already bought a plan.

For example, let’s say you purchased a plan with Blue Cross Blue Shield (BCBS). Well, auto-renewed you to Ambetter, who are now sending you bills. Simply, ignore the bills from Ambetter. Especially if you already paid and have effectuated your policy with BCBS, then can ignore Ambetter. On the other hand, be aware of bills from BCBS with whom you are enrolled. Until you’ve verified that the premium was charged to your bank account or credit card, don’t ignore bills from BCBS. If the payment didn’t go through, get with your agent and make sure to pay the premium before the deadline.

Since insurance is oftentimes overwhelmingly confusing, we want to shed light on this industry by answering YOUR questions.  So if you have any questions or concerns, comment below and your question may be the topic of our next video!

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