Open-Enrollment in August for Self-Employed Floridians’ Guaranteed-Issue Health Insurance

Self-employed Floridians in need of health insurance can obtain it through an open-enrollment period during the month of August. The open enrollment period requires insurance companies and Health Maintenance Organizations to offer applications for coverage to the self-employed on a guaranteed-issue basis from Aug. 1 to Aug. 31 each year, with a plan start date of Oct. 1. The open enrollment period enables individuals without health coverage to obtain insurance. Additionally, it provides Floridians that currently have health coverage the opportunity to switch to another insurance plan.

“We need to get the word out that the window of opportunity only comes once a year for the self-employed seeking guaranteed-issue health coverage,” Tom Gallagher, Florida’s CFO said. “We want to help ensure that Floridians gain access to health care coverage. This enrollment period comes only once a year for the self-employed seeking guaranteed-issue health coverage, so now is the time to get insurance or review your current policy.”

Small employers are eligible if they have just one employee who qualifies for coverage, and if they did not go into business primarily for the purpose of buying health insurance. A sole proprietor, independent contractor or self-employed individual is considered a small employer only if all of the conditions and criteria established in the law are met.

Guaranteed-issue means insurers and HMOs must offer coverage without regard to health status. Companies that write coverage for individuals are required to offer only “basic” or “standard” plans.

With the passage of the Affordable Healthcare for Floridians Act last year, coverage options for employers include health savings accounts and health reimbursement arrangements. HSAs, which operate like Individual Retirement Accounts, allow people to save their own money in a tax-free account for use on health related expenses. If the money is not spent, it will roll over annually and continue to accumulate until the policyholder is age 65 at which time the money can be used for any purpose.

“These accounts will help Floridians pay for out-of-pocket health costs with pre-tax dollars and empower them to make wise financial decisions about their medical care,” said Gallagher, who co-chaired the Governor’s Task Force that suggested many of the new choices. “These accounts will not only help lower overall costs in the market, but they provide Floridians seeking health care coverage another option. Additionally, young, healthy individuals who so often choose to go without insurance will be more inclined to purchase this type of coverage. The goal is to provide all Floridians access to affordable health care.”

Self-employed Floridians who apply for coverage must show documentation verifying that they are operating an active business, including tax forms, license information and business receipts.

A list of insurance companies offering coverage is posted on the DFS website at www.fldfs.com/Consumers/small_group_market_carrirers.htm. For available benefits, go to www.fldfs.com/companies/lh_fr/is_LHFR_Small_Emp_Benefit_Plan.htm.
Consumers can contact DFS’s toll-free consumer helpline at 1-800-342-2762 to request a free copy of its health insurance consumer guide.