Renewal Information

Introduction

Each year, we will send you a packet of information about renewing your coverage for the upcoming year. This happens right before the Open Enrollment period. In general, if you keep paying your monthly premiums, you can renew for your upcoming year of coverage into:

• Your current plan, if it is available for the next year, or
• A similar plan from the same insurance company, if your current plan won’t be available for the next year.

If you want to enroll in a different plan, you can shop and change plans during Open Enrollment.

Section 1: When will my coverage be renewed?

Health plans renew on January 1st of each year. Dental plans renew every 12 months in relation to your plan’s effective (start) date.

While all health and dental plans’ coverage year ends on December 31. See the example below:

Section 2: What mail will I receive as it related to my yearly renewal?

The Health Connector will send a few important mailings leading up to the yearly Open Enrollment that includes your eligibility and renewal information for the next plan year.

Eligibility notifications

You will start getting eligibility notifications in the late-summer/early-fall. In these notifications, you will learn what you may be eligible for the next plan year based on the information in your application as well as state and federal data services. When you get this preliminary eligibility notice, review the information carefully. If you have not updated your application, please be sure to do so as soon as possible.

Your final eligibility notice is mailed close to Open Enrollment time. If you have updated your information, it includes what programs and cost savings you are eligible for the next plan year.

Plan renewal information

The month before Open Enrollment begins, you will get information about your options for renewing health insurance for the next year. Generally, if your current plan is available next year, we will automatically renew you into that plan again, unless you decide to shop for a new plan during Open Enrollment. If your current plan is not available, we will suggest a similar plan for you based on your current enrollment. You will be automatically enrolled in that plan for the next year unless you choose a new plan during Open Enrollment. When you receive your renewal plan information, you will also learn what your new monthly premium costs will be for the next year’s plan.

 

Section 3: What things should I consider during plan renewal time?

How to sign into your account online if you applied by paper or forgot your login information

The Health Connector uses a secure account service called Optum ID to sign into your account.

If you applied by paper and do not have online account login information, call Health Connector customer service. When you call, you will need to have an email address ready. Learn how you can set one up for free if you don’t already have one →

A representative can add your email to your account and you will get an invitation from Optum ID at that email address to set up your sign in information, including a username, password, and security questions.

If you forgot your login information, go to the Optum ID sign in page and click either the

• “Forgot Optum ID” if you don’t remember either your username (which is the email address you used when you signed up) or your password, or
• “Forgot Password” if you remember your username but not your password).

Doctors and medical facilities

Health and dental plans that are accepted by providers (such as doctors and nurse practitioners) and medical facilities (such as hospitals and community health centers) can change. When it is time to renew your plan, use the provider search tool and check in with doctors, specialists, and facilities you use to make sure they are in the network of the plan you are considering for next year.

See: Information about provider networks

Premiums

A premium is the amount you pay each month for your health or dental insurance and can change every year. When you are renewing your plan, it’s important to compare plans that may be more affordable if your premium increased. You may find the same or similar benefits at a lower cost with a different insurance company.

Prescription medications covered

Each plan covers certain prescription medication in what is called a formulary. A formulary, also called a drug list, is a list of prescription drugs covered by a health plan. When it is time to renew your plan, use the insurers drug lookup tool on their website to check and see if any prescription drugs you take are covered by a plan.

Many plans arrange the cost of prescription drugs by level or tier. For example:

• Tier 1—Generic Drugs (lowest cost)
• Tier 2—Preferred Drugs
• Tier 3—Non-Preferred Drugs
• Tier 4—Specialty Drugs (highest costs)
• If prescriptions you have are not covered or are in higher Tier 3 or 4 in a plan you are considering, be sure to check the drug costs in the Summary of Benefits and Coverage.

Out-of-pocket costs

When comparing plans, it’s important to look at plan’s out-of-pocket costs. These costs include deductibles, co-insurance, and co-payments. These are costs that are separate from monthly premiums, balance billing amounts for out-of-network providers, or the cost of non-covered services.

If you use a lot of health care, it is important to review each plan’s Summary of Benefits and Coverage that you are considering to see if the out-of-pocket costs are affordable.