Marketplace

Open Enrollment for the Health Insurance Marketplace ended January 31, 2016, but there are some qualifying life events and complex situations related to applying in the Marketplace that may qualify you for a Special Enrollment Period.  For more information on what these qualifying life events are visit:

http://www.healthcare.gov/how-can-i-get-coverage-outside-of-open-enrollment/

If you think you qualify for a Special Enrollment Period, visit www.healthcare.gov or contact the Marketplace Call Center at 1-800-318-2596.

Medicaid (including Private Option) has no limited enrollment period.  You can enroll any time during the year if you qualify.  Visit www.access.arkansas.gov or contact your local DHS for more information.

All financial assistance available through the Health Insurance Marketplace is based on your annual household income in reference to the 2016 Federal Poverty Level (FPL) by the size of your household.

2016 Federal Poverty Guidelines

Federally facilitated marketplaces will use the 2016 guidelines to determine eligibility for Medicaid and CHIP.

If your annual household income is…

  • Between 0% – 100% FPL, you may qualify as an individual for traditional Medicaid if other qualifications are met.
  • Less than 138% FPL, you and your family may qualify to be eligible for commercial coverage with no out-of-pocket premium cost based on the Arkansas Healthcare Independent Option Act.
  • Less than 250% FPL, you and your family may qualify for significant reductions in out-of-pocket deductible and co-payment costs through Cost-Sharing Reductions.
  • Less than 400% FPL, you and your family may qualify to receive Premium Tax Credits that can be used to lower the cost of monthly premiums.

Please note: If you are eligible for Employer-Sponsored Group Health Coverage that will cost less than 9.5% of the employee’s annual income, you may not qualify for some of the financial assistance through the Health Insurance Marketplace.

For tax year 2016, the penalty will rise to 2.5% of your total household adjusted gross income, or $695 per adult and $347.50 per child, to a maximum of $2,085.

For tax year 2017 and beyond, the percentage option will remain at 2.5%, but the flat fee will be adjusted for inflation.

Have questions about the Health Insurance Marketplace?

Visit http://www.arhealthconnector.orghttp://www.healthcare.gov or call Toll Free 1-800-318-2596.

Have questions about Medicaid (including Private Option)?

Visit http://www.access.arkansas.gov or contact your local DHS office.

Need access to printable applications forms, exemption applications, eligibility appeals forms, or instructions?

Visit https://marketplace.cms.gov/applications-and-forms/applications-and-forms.html
Revised 10/1/2016

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