In Employee Benefits, Health Insurance

Do I Have To Take The Group Health Plan?

The short answer is no.  Choosing not to enroll in your company’s group health plan may be the best thing for you. For example;

  1. You may want a plan with better benefits.
  2. The group health is expensive.
  3. The group health plan uses an HMO whose facilities you don’t use.

But before you make that decision, there are some things you need to consider. One, is open enrollment.

Open Enrollment Changes Everything.

Open Enrollment

Group Health Open Enrollment








Individual health insurance now has an open enrollment period. That period will determine if you can purchase individual health insurance inside or outside of the Marketplace. Inside the Marketplace means going through That means setting up an account and possibly receiving a tax credit. Outside of the Marketplace means going directly to the insurance company. No tax credits and no account. Open enrollment for either runs from November 1st, 2015 through January 31st, 2016. Here’s’s website announcement Marketplace 2016 Open Enrollment Dates .

This is very important. If your group health plan has a renewal (start date) date of January, February or March 1st, you can purchase individual health insurance inside or outside of the Marketplace. For other start dates things can get complicated. If your group has a renewal date of July 1st. And you choose not to enroll. Your only option may be to purchase insurance through inside of the exchange. Why?

Opposing Views

Most insurance carriers view not choosing to enroll in your company’s group health plan as a voluntary loss of benefits. And because of that classification they don’t consider it to be a qualifying event. And without a qualifying event you can’t enroll into an individual health insurance plan outside of open enrollment.

The Marketplace on the other hand views that same decision as a qualifying event. That event qualifies you for a Special Enrollment Period. And that SEP allows you to enroll outside of open enrollment. This has nothing to do with whether or not you’ll get a tax credit. This simply means that inside of the Marketplace you can purchase health insurance.

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