Pennie Offers Two New Special Enrollment Periods for Health Insurance
Pennie is a new state-based health insurance marketplace, where uninsured Pennsylvanians can purchase health insurance, often with substantial financial help. The annual enrollment period for Pennie, or the time during which anyone can purchase insurance, occurs in the fall for coverage that begins January 1 of the following year. In addition to the annual enrollment period, there are also Special Enrollment Periods (SEPs) for uninsured Pennsylvanians who fall into certain categories or experience certain life events. For example, getting married or having a child could be a Special Enrollment Period to get insurance through Pennie outside of the annual enrollment period.
For 2022, Pennie announced two new Special Enrollment Periods: the first is for people with income is less than 150 [percent of the Federal Poverty Level (FPL), and the second, called “Path to Pennie”, is for uninsured Pennsylvanians filing a state tax return. Both SEPs are described below.
1. Special Enrollment Period for Individuals or Families with Low Incomes
Beginning in 2022, Pennie will allow enrollment throughout the year for people with income up to 150 percent of the FPL, which is $19,320 per year for a single person and $32,940 for a family of three in 2022. A new special enrollment period will be offered each month and plan choices will include zero-premium plans with vastly reduced deductibles. Added enrollment opportunities will make it easier for people to sign up for premium-free plans with low cost-sharing (amounts that must be paid to get care, such as a copay) throughout the year.
Those who are not yet enrolled with Pennie but are below 150 percent of FPL will automatically get this SEP upon submission of their application for insurance. Pennie reports this automation will be fully functional as of summer 2022. If an individual has an existing application submitted with no enrollment, they may update their income information and receive updated eligibility results so that they may shop for a new plan immediately.
2. Easy Enrollment: Path to Pennie
The “Path to Pennie” program makes it easy for uninsured income tax filers to get medical and dental insurance coverage through Pennie. Path to Pennie can also provide financial assistance to help reduce the cost of the insurance premium and the costs of accessing health care.
As uninsured tax filers complete their Pennsylvania State Income Tax Return, they can elect to receive more information about enrolling in health coverage available through Pennie by completing Form REV-1882, Health Insurance Coverage Information Request. By completing Form REV-1882, the PA Department of Revenue will securely send the information to Pennie to create an account on the individual’s behalf.
After the completed Form REV-1882 is submitted, beginning April 1, 2022 Pennie will send a notice with three important pieces of information: 1) an access code to open a Pennie account; 2) an estimate of the financial aid the individual is likely to receive toward the cost of health insurance and health care; and 3) a 60-day Special Enrollment Period to shop, apply and enroll in health coverage. This is a Special Enrollment Period because the typical annual enrollment period for coverage through Pennie has ended for 2022. Note that there are other Special Enrollment Periods for certain situations such as moving, losing current health insurance, and getting married, to name a few.
Once the notice with the above information is received, individuals can begin shopping for insurance at Pennie.com. The “shop” icon allows individuals to explore insurance options based on their zip code and age. To purchase insurance, log-in with the Access Code provided in the notice from Pennie and complete the application. The first month’s premium must be paid before the coverage starts. Individuals who fail to enroll within the 60-day Special Enrollment Period will not be eligible to enroll until fall 2022 for coverage that will begin on January 1, 2023.
Individuals who complete REV-1882 don’t have to wait to receive the notice from Pennie. Contact Pennie at 844-844-8040 to find out how to get the Access Code.
For more information on the Path to Pennie (including a short video in English and Spanish) or to get help from a health insurance assister or health care broker go to Pennie's website.
Consumers needing additional information on Pennie coverage may call Pennie customer service at 1-844-844-8040. Those who need help with assessing their eligibility for Medicaid or the Children’s Health Insurance Program (CHIP) should call PHLP’s Helpline at 1-800-274-3258.