In general, health insurance policies are effective for 12 months, and the period during which coverage is provided is called the plan’s benefit year.
For individual health insurance policies — whether purchased on or off the exchange — the benefit year runs on a calendar basis, from January 1 – December 31.
However, not all policies will be effective for the full 12 months. This is because the start date of an individual policy could be later than January 1 for one of two reasons:
- Open enrollment extends past January 1. For example, open enrollment for 2016 plans ran through January 31, 2016, and consumers could enroll with an effective date as late as February 1 or March 1 of 2016.
- Special enrollment periods are available throughout the year, meaning consumers may enroll in a new policy whenever they have a qualifying event.
Regardless of a plan’s start date, however, the benefit year for all non-group plans ends on December 31
A new benefit year begins on January 1.
This means the cost-sharing features of a plan (e.g., deductibles, out-of-pocket limits, etc.) start over each January 1.
January 1 is also the date when premium rates on a non-group policy can change.
What Will Happen on December 31?
Your health insurance carrier will most likely give you the option to automatically re-enroll in coverage at the end of your benefit year.
But since premiums and plans can change from year to year, it will be important to carefully compare your options for next year’s coverage.
Open enrollment for 2017 health insurance begins in the fall of 2016 and runs through early 2017. During these dates, you can switch to a new 2017 individual or family plan for any reason. Your new coverage effective date will be determined based upon the date you enroll.
Help Choosing the Right Health Insurance
Virginia Medical Plans is available to help! Contact our office as open enrollment approaches so we can help you choose the right plan to meet your specific needs.
Reach us by phone 703-707-8270 or email jkatz@vamedicalplans.com.
