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Plan maker: PPACA enrollment calendar flunks buzz test

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Players in the U.S. individual major medical market may have a serious communication problem: Widespread consumer ignorance about the Patient Protection and Affordable Care Act (PPACA) open enrollment period system.

Health Insurance Innovations Inc. (HII), a company that develops short-term health insurance products and other health insurance products not regulated by PPACA, has published data supporting that conclusion in a summary of results from an online survey of 1,083 U.S. adults. The survey was conducted April 15 through April 17.

HII (Nasdaq:HIIQ) gave the survey participants, who were all sophisticated enough to be using the Internet, a multiple-choice test. It asked the participants whether the individual health insurance enrollment deadline for 2015 was Feb. 15, April 30, Oct 15, Nov. 1 or “I don’t know.”

Only 18 percent knew that the official deadline was Feb. 15. 

Another 14 percent gave another reasonable answer: April 30. In most states, insurers will be letting consumers who say they first learned about the PPACA uninsurance penalty when they filed their income taxes for 2014 enroll in coverage up until April 30.

Eight percent said the enrollment deadline was Oct. 15 or Nov. 1, and 60 percent admitted that they didn’t know what the deadline was.

Regulators and insurers developed the open enrollment period system in an effort to keep the PPACA underwriting rules that took effect Jan. 1, 2014, from encouraging consumers to wait until they get sick to pay for health coverage.

To push consumers to pay for coverage even when they’re healthy, insurers sell coverage to consumers on a true guaranteed-issue basis only during the open enrollment period. During the rest of the year, consumers who want to buy individual major medical coverage must apply for a special enrollment period (SEP).

The open enrollment period system has a direct effect on enrollment in the PPACA exchange system, and it appears to have a direct or indirect effect on enrollment in off-exchange major medical coverage throughout the country.

The open enrollment period for 2014 started Oct. 1, 2013, and officially ended March 31, 2014.

The open enrollment period for 2015 started Nov. 15, 2014, and officially ended Feb. 15, 2015.

The open enrollment period for 2016 is set to start Nov. 1, 2015, and end Jan. 31, 2016.

Analysts at HII say the U.S. Department of Health and Human Services (HHS) has confused consumers by changing the open enrollment period beginning and end dates every year.

HHS has also confused consumers by offering many consumers, including consumers who say they have had technical problems, easy access to SEPs after the end of the official enrollment period, the analysts say.