QUESTION

What happens if my marketplace insurer decides to discontinue its health plans on the marketplace?

Post enrollment issues | Individual Health Insurance
ANSWER

If your insurer decides to discontinue offering health plans, it must provide you with notice of the discontinuation at least 90 days before coverage is discontinued. Other state specific requirements may also apply. If you like your insurer, you may want to see if the insurer is offering health plans off the marketplace that fits your needs. Note, however, financial assistance is only available with marketplace coverage. If your insurer exits the marketplace and your plan is discontinued outside of the open enrollment period, you will be eligible for a special enrollment period to apply for new coverage on and off the marketplace.

If your insurer is leaving the market altogether and won’t offer coverage on or off the marketplace, it must provide you with notice of its withdrawal and discontinuation of coverage at least 180 days before coverage is discontinued. Other state specific requirements may also apply. You will be eligible for a special enrollment period to purchase coverage on or off the marketplace. (45 C.F.R. § 147.106; 45 C.F.R. § 156.1255; 45 C.F.R. § 155.420).

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