Open Enrollment – Frequently Asked Questions

Since Open Enrollment began on November 15, 2014, Balanced Care has received many frequently asked questions.      We decided to put them together to assist you in getting the answers you need.


  • When is Open Enrollment?     Open Enrollment for 2015 coverage runs from November 15, 2014 until February 15, 2015.
  • Is this the only time I will be able to purchase health insurance?      If you are not getting your health insurance through an employer, the open enrollment period is the only time you will be able to purchase a health plan unless you qualify for a special enrollment period.
  • What is a special enrollment period?    A special enrollment period is a time outside of open enrollment during which you or your family can sign up for a health plan.     This includes changes to family status such as marriage, birth of a child, or loss of your health plan through an employer.     In the marketplace, you have up to 60 days following a change in family status and up to 30 days for the loss of a job.
  • My current plan didn’t start until March 1, 2014.     Will it renew or should I pick another plan?    If you enrolled in a marketplace plan in 2014, your coverage will end on December 31, 2014.     This doesn’t matter whether you signed up for the plan in January or March.     To continue that plan, you can either renew it or choose a new plan.    Either way, this will have to be done by February 15, 2015.
  • Can my plan begin the next day if I wait until the end of the month?      If you enroll into a plan before the 15th of month, your plan will begin on the 1st day of the following month.      If you enroll into a plan between days 16 and the last day of the month, your plan will begin on the second following month.     For example, if you enrolled into a plan on December 18, 2014, the effective date for your plan would be February 1, 2015.
  • What happens if I don’t enroll in a plan?    If you don’t have health coverage in 2015, you will have to pay a penalty.     The penalty for 2015 is 2% of your income or $325.00 per adult and $162.50 per child whichever is greater.
  • How do I know if I qualify for lower costs and/or a subsidy?    To find out if you may qualify for a subsidy or lower costs, please click on the chart below.

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  • Can I be turned down for health insurance?     No, you cannot.     The Affordable Care Act is a law and it states that no one can be turned down or rated higher because of a health condition.
  • How do I know what my  plan will cover?    Every health plan now has to have 10 essential benefits.      These benefits include ambulatory services, hospitalization, emergency services, prescription drug coverage, laboratory services, pregnancy, maternity, and newborn care, mental health, preventative services, rehabilititive services and pediatric services.
  • Do I have to pay for services such as pregnancy even though I will never use it?      Yes, you do.     Every plan must offer that benefit even if you will never use it.
  • Do I have to report income changes if I received a subsidy in 2014?      Yes, you have to report income changes as soon as they happen.     Not updating your information can result in losing eligibility in tax credits.
  • When should I report changes?     You should be reporting changes as soon as they happen.

Balanced Care is always here to help you with your insurance needs.     We invite you to take advantage of a free consultation, learn if you qualify for a subsidy, and let us help you enroll into a plan that best fits your specific needs.       If you have further questions or would like to see some additional questions answered for you, please reach out to us.      We look forward to speaking with you soon.


Terri Trepanier is the owner of Balanced Care Health and Supplemental Insurance and a licensed broker in Maine and New Hampshire.   Her specialty is working with small businesses, individuals, and families with their health and life insurance needs.      She is certified to offer health plans both on and off the exchange and is contracted with every insurance company that offers plans in both New Hampshire and Maine.     Her other passion is assisting Medicare beneficiaries with their Medicare Supplemental, Medicare Part D Prescription Drug Plans, and Medicare Advantage plans.    Terri knows the importance of insurance products and how they help individuals and families.    She continually strives to give her clients the peace of mind that each of us deserves.

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