2022 Open Enrollment
The rule extends the annual individual market Open Enrollment Period for 2022 and future benefit years to allow consumers more time to review plan choices, seek in-person assistance, and enroll in a plan that best meets their needs. The annual Open Enrollment Period for all individual-market Marketplaces using the federal eligibility and enrollment platform and off-Marketplace individual market plans in states with such Marketplaces for 2022 and future benefit years will be November 1 of the prior year through January 15 of the benefit year. State Marketplaces not using the federal eligibility and enrollment platform maintain flexibilities regarding effective date rules and Open Enrollment end dates, provided the Marketplace’s Open Enrollment end date is no earlier than December 15 of the calendar year preceding the relevant benefit year.
Monthly Special Enrollment Period (SEP) for Advance Payments of Premium Tax Credits (APTC)-Eligible Consumers with Household Income up to 150% of the Federal Poverty Level (FPL) whose Applicable Taxpayer has an Applicable Percentage of Zero
To provide more opportunities for certain low-income consumers to access coverage with low or no premiums after APTC, such as under the American Rescue Plan (ARP), Marketplaces will now have the option to provide a monthly SEP for APTC-eligible consumers with a projected annual household income no greater than 150% of the FPL. The rule will permit Marketplaces to provide a SEP for periods of time during which premium tax credits are available without the applicable taxpayer having to contribute toward their applicable portion of premiums before premium tax credits become available, such as those currently available under section 9661 of the ARP. Marketplaces on the federal platform will implement this SEP by providing eligible consumers with a pathway through the HealthCare.gov application during such periods of time.