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Health Benefits

Qualified Health Plans on the NYS of Health Marketplace: Changes under COVID-19

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Summary

The NY State of Health has opened a special enrollment period allowing individual who are uninsured to enroll in a Qualified Health Plan, as well as allowing a grace period to pay for a health plan’s monthly premium. The period has been extended through December 31st, 2020.

If you are a Benefits Plus subscriber, for additional information on Qualified Health Plans, refer to Benefits Plus, Health Programs, Affordable Care Act, Plans on the Marketplace & Who Qualifies, Qualified Health Plans. For subscription information visit: https://bplc.cssny.org/home/subscription_options.

Special Enrollment Period

NYS: EXCEPTIONAL CIRCUMSTANCES

New York State has created an “exceptional circumstances” special enrollment period for anyone who is uninsured during the COVID pandemic. These individuals can enroll in a Qualified Health Plan on the NY State of Health Marketplace or directly with a health insurer from March 16th through December 31st.

Individuals apply for coverage through NY State of Health on-line at https://nystateofhealth.ny.gov, by phone at 855-355-5777, or by working with Navigators: https://info.nystateofhealth.ny.gov/IPA.

For additional information on special enrollment periods visit.

FEDERAL SPECIAL ENROLLMENT PERIOD

Outside of NYS, individuals may qualify for a Special Enrollment Period if they lost health coverage through their employer more than 60 days ago but since January 1, 2020 and were prevented from enrolling in health coverage due to the national emergency on COVID-19.

No Cost Sharing for COVID-19 Testing

There is no cost sharing for Covid-19 testing for individuals enrolled in qualified health plans.

When Household Circumstances Have Changed

Households should update their account within 60 days of the change on the NYS of Health Marketplace. Anyone who has experienced a change in income, employment or other major life event, may qualify for more financial help that could lower their health insurance costs.

Payment of Plan Premiums

Individuals enrolled in subsidized or unsubsidized coverage in NYS may have more time to pay their health insurance premiums during the COVID-19 emergency. For more information on this grace period visit the Department of Financial Services at https://www.dfs.ny.gov/press_releases/pr202003301 and the NYS of Health Marketplace.

For a fact sheet, click here.

NY State of Health Fact Sheets

How COVID-19 Cash Aid Impacts the Premium Tax Credit and Cost Sharing Reduction Subsidy

ECONOMIC IMPACT PAYMENTS

The CARES Act Economic Impact payments (EIP) (up to $1,200 per individual, $500 per qualifying child) will not count when determining eligibility for the premium tax credit or the cost sharing reduction benefit.

PANDEMIC UNEMPLOYMENT COMPENSATION

The $600 per week in Pandemic Unemployment Compensation will count when determining eligibility for the premium tax credit and the cost sharing reduction benefit. The base Unemployment Insurance benefit, including PUA, also counts as unearned income.