Individuals & families
You have three weeks and four columns of numbers.
Open Enrollment is the one month a year when the whole household's medical exposure is decided, and almost nobody is given the table they need to decide it. That is the entire job of this desk.
What the desk does
Three services, all of them free to you
Broker compensation is paid by the carrier and filed inside the rate. There is no consumer-side fee at any point, and no plan on our comparison is weighted by what it pays us.
Service 01
Plan selection
A structured comparison of every plan in your rating area, run against your own physicians, prescriptions and expected utilisation.
Read the methodService 02
Subsidy review
Income modelling, FPL banding and cost-sharing eligibility, done before you enrol rather than discovered when you file.
Read the methodService 03
Special enrollment
Event verification, document assembly and effective-date planning for the 60-day window after a qualifying life event.
Read the method
Observed at the desk
The five things households get wrong
None of these are stupid mistakes. Every one of them is the rational response to being shown a price and nothing else.
- 01
Shopping on premium alone
The premium is one of five numbers. Deductible, coinsurance, maximum out-of-pocket and the formulary decide what a bad year costs, and none of them appear on the price tag.
- 02
Guessing at income
The credit is computed from projected modified adjusted gross income. Guess low and you repay at tax time; guess high and you overpay all year for nothing.
- 03
Assuming the network followed you
Networks are set per rating area and change every plan year. The physician who was in network in November is not automatically in network in January.
- 04
Letting auto re-enrolment decide
Doing nothing is a decision. The Marketplace will crosswalk you into something, recalculate your credit against a new benchmark, and send the bill.
- 05
Missing December 15
Enrol after it and coverage starts February 1. That gap is a full month of exposure for anything that happens in January.
None of this affects whether you can be covered. Every Marketplace plan is guaranteed issue.1
Outside Open Enrollment
Qualifying life events, and the sixty-day window
Missing Open Enrollment is not the end of the year. A qualifying life event opens a special enrollment period, and most of them run sixty days.
| Event | Window | Usual proof | Coverage starts |
|---|---|---|---|
| Loss of job-based coverage | 60 days before and after | Termination letter or COBRA notice | First of the following month |
| Marriage | 60 days after | Marriage certificate | First of the following month |
| Birth or adoption | 60 days after | Birth certificate or placement order | Date of the event |
| Permanent move | 60 days after | Prior coverage plus new address | First of the following month |
| Loss of Medicaid or CHIP | 60 days before and after | State termination notice | First of the following month |
| Divorce with loss of coverage | 60 days after | Decree plus termination notice | First of the following month |
| Gaining lawful presence | 60 days after | Immigration documentation | First of the following month |
| Income change to under 150% FPL | Monthly, where available | Attested income | First of the following month |
Voluntarily dropping other coverage does not open a special enrollment period. Neither does simply changing your mind about a plan you already chose.
Almost every failed special enrollment is a document that nobody uploaded before a deadline nobody noticed.2How the desk runs an SEP
Frequently asked
The questions the desk actually gets
No. Broker compensation is paid by the carrier and is already built into the filed rate, so the premium for a given plan is identical whether you enrol through us, directly with the carrier, or on HealthCare.gov. There is no consumer-side fee at any point, and no plan on our comparison is weighted by what it pays.
Because cost-sharing reductions attach to Silver plans by statute. Between 100% and 250% of the federal poverty level, a Silver plan is silently upgraded to a 73, 87 or 94 actuarial-value variant, and the 94 variant is richer than most Gold plans while still costing a Silver premium. Choosing Bronze in that income band trades a small monthly saving for a very large deductible.
Advance credits are reconciled on IRS Form 8962 when you file. If you earned less than you projected, you receive the difference as a refundable credit. If you earned more, you repay some or all of the excess, subject to repayment caps that scale with income. Report income changes to the Marketplace during the year and the correction happens in small monthly steps instead of one bill in April.
No. Every Marketplace plan is guaranteed issue. There is no medical underwriting, no condition-based rate-up, and no waiting period before an existing condition is covered. Rates vary only by age, ZIP code, tobacco use, plan and household composition.
The Marketplace will usually re-enrol you into your current plan, or crosswalk you into the carrier's nearest surviving design if yours was discontinued. That sounds harmless and often is not: your credit is recalculated against a new benchmark, and a plan that was well priced last year can move sharply. Auto re-enrolment is a safety net, not a decision.
Most applications clear without any. If the Marketplace cannot match your data to federal records it raises a data-matching issue with a deadline, usually 90 days. Income is normally cleared with recent pay stubs, a prior-year 1040, or a signed self-employment statement. Identity and lawful presence have their own document lists. Missing the deadline ends the credit, so upload early.
Next
Bring your ZIP code and your prescription list.
That is genuinely all the preparation required. Forty minutes, no fee, and a written recommendation you can disagree with on the merits.