How to Report Changes to the Marketplace

The Marketplace plays a very important role in the Affordable Care Act (ACA), also informally known as Obamacare. In order to determine whether or not applicants are eligible for coverage, applicants must submit all their information regarding finances and family size to the ACA Marketplace. Initially, submitting information to the Marketplace is fairly straightforward, but it is important that all Marketplace participants continue to update their information. Reporting changes on the Marketplace may end up having large effects on the types of health plans that are available for the participant. The sooner the changes are reported, the more time the participant has to prepare for any changes. If a participant willingly chooses not to update his or her information, he or she may end up in serious trouble. More information regarding how to report changes to the ACA Marketplace is covered in the following areas:

  • What Changes Must Be Reported to the Marketplace
  • How to Report Changes to the Marketplace
  • Changing Plans Under a Special Enrollment Period

What Changes Must Be Reported to the Marketplace

One of the most common questions Marketplace participants have is what kind of changes must be reported to the Marketplace. There are only a couple of changes participants must report to the Marketplace, but they cover very important information. One of the first changes that must be reported has to do with income. Participants must report either increases or decreases in their incomes, such as getting a new job, getting a promotion or losing a job.

Relating to income, participants must also update any information regarding the size of their households. Participants that get married, go through divorces, are having children, or who have dependents moving out or back in must report this information. If the change in the family has an effect on the income, such as from a couple getting married and now having shared income, this information must also be reported to the Marketplace. Lastly, participants must report any changes to their health insurance. Typically, these types of changes occur from a participant getting insurance coverage from a new job, or becoming eligible for plans outside of the Marketplace after they get married.

How to Report Changes to the Marketplace

Because it is so important to report changes, the Marketplace website is designed to be very accessible. The website, itself, contains detailed instructions on how participants can update their information. The first step is just to login to the account on the Marketplace. Once the participant is logged on, he or she selects the, “Report a life change” option from the dropdown menu on the left side of the screen. Once selected, the participant is brought to another page where he or she can submit any life changes, such as a change in income or the size of his or her family.

Participants who are unable to access the website or who have trouble imputing the changes have the option of calling the Marketplace Call Center to report their changes. In most situations, the Marketplace recommends trying to use the website before resorting to calling the Marketplace for assistance. Updating information from the website is much easier and guarantees that all the changes go through quickly. Calling the Marketplace is still a viable option, but callers may end up on hold for long stretches of time, depending on the call volume of the Marketplace. Unlike other changes, participants are not able to report any major life changes by mail.

Changing Plans Under a Special Enrollment Period

The most complicated part of reporting life changes is when the life change has an impact on what type of coverage is available. Depending on what the change was, or how big the change was, participants may be eligible for new coverage. If this happens, participants receive an eligibility notice, telling them they qualify for a special enrollment period. Under normal circumstances, Marketplace participants are not able to change their active insurance plans. The special enrollment period gives eligible Marketplace participants the chance to change their plans. Participants have 60 days to pick different plans. Participants may either shop for the plans online, or they can call the Marketplace call center to discuss receiving new plans.

Not all participants are eligible for special enrollment periods to change health plans. In most situations, the special enrollment period is only used for participants that are no longer eligible for their existing plans. It would be unfair to deny someone insurance coverage just because his or her life situation changed, so these participants are given small grace periods to get new coverage. If a participant is eligible for a better plan, but may continue to still use his or her existing plan, it is unlikely he or she will get a special enrollment period. However, these participants can still sign up for new plans for the following year.