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Open Enrollment

Open Enrollment

RENEW NOW

At Common Ground Healthcare Cooperative (CGHC) members come first. We are committed to providing trusted and understandable information. That’s why we make our health insurance plans simple to use and easy to understand.

OPEN ENROLLMENT DEADLINES

For January 2025 Coverage
enrollment ends Dec. 15, 2024

For February 2025 Coverage
enrollment ends Jan. 15, 2025

For Members Renewing Coverage

 

Open Enrollment Period and Plan Effective Dates

  • The 2025 health plan detailed in your renewal packet is set up for you in our system. To ensure you have coverage, we are required by the government to automatically enroll you in this plan if you don’t select a different plan by December 15.

 

  • Tax credits are only available for On-Exchange plans. They are based on household income information.
    • On-Exchange plan members – To ensure the most accurate tax credit is applied to your plan, be sure to:
      • Actively renew your coverage in the  Pay My Premium portal by December 15.
      • Update your estimated household income for the new plan year.
    • Off-Exchange plan members – Tax credits are not available on the plan detailed in your renewal packet. For instructions to see if you qualify for a tax credit on a CGHC On-Exchange plan, please see your renewal packet.

 

  • Early in December, we send invoices for January coverage. We use the information that is on file for your 2025 enrollments as of December 1. Payment will be due on December 25.

 

  • Any change made between December 2nd and December 15 that impacts your premium for January coverage will result in a revised invoice being generated.
    • You can view the revised invoice for January coverage in the CGHC Pay My Premium portal between December 21 – 25 when payment is due.

 

  • When Open Enrollment ends on January 15, you will no longer be able to make changes to your plan – unless you qualify for a Special Enrollment Period (SEP).  Click here for details about the SEP.

 

ID Cards

  • For members renewing their coverage, we will mail your ID card(s) mid-December.
    • Your 2025 ID card will reflect whatever plan information is on file as of December 1 and will include a new member ID number.
  • What if I change plans?
    • If you change plans between December 1 and January 15, we will mail a new ID card within 3-5 business days after we receive your first month’s payment.

 

NOTE: Temporary ID cards for 2025 plans can be downloaded from the Pay My Premium portal beginning on December 21.

 

If You Are Looking for New Coverage

 

Open Enrollment Period and Plan Effective Dates

For a January 1 effective date – enroll between November 1 and December 15.

For a February 1 effective date – enroll between December 16 and January 15.

 

  • How do I activate my new health plan?
    • You must pay in full for your first month of coverage to activate your health plan.

 

  • When do plan benefits become available?
    • Plan benefits are available on/after your selected effective date and your first month’s payment is received.

 

  • What payment options are available?
    • We accept payments online, by phone and mail.

 

  • When will I receive my ID card(s)?
    • ID cards will be mailed 3-5 business days after we process your first month’s payment.
    • Temporary ID cards can be downloaded from the Pay My Premium portal.

 

 

Ready to Enroll?

For important dates related to Open Enrollment, details about 2025 ID cards, and what’s new for the 2025 Plan Year, please refer to the Fall Member Newsletter.

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Additional FAQs and Forms

Frequently Asked Questions

Quote - How do I get a quote for a CGHC health plan?

To receive a quote for a CGHC Individual and Family health plan, visit the Looking for Insurance page on our website. Click Browse Plans & Prices then complete all the requested information and click Get Quote. Be sure to enter your estimated household income to see if you qualify for help lowering your monthly premium payment.

 

If you qualify for the Advance Premium Tax Credit (APTC) or a Cost Sharing Reduction (CSR) from the federal government, a pop up will appear. To use those savings, select View Marketplace Plans. Otherwise, select Return to Plans to view other options.

Renewal Packet - Is my renewal packet available to view online?

Yes, you can view your renewal packet by logging into the Pay My Premium portal. On the home page, select the click here option to view your renewal offer. Your new offer will be displayed, and you can select the View Renewal Letter for more details. The renewal option will only be visible November 1st through December 15th.

Renew - How do I renew my current plan?

We strongly encourage our members to actively renew CGHC coverage via the Pay My Premium portal.

  • On the portal’s home page, select the click here option, to view your renewal offer.
  • When you are ready to accept the renewal plan, simply select Renew My Coverage. This option will be available November 1 through December 15
  • Actively renewing coverage and updating your information is the best way to avoid any miscommunication with the Federal Health Insurance Marketplace ®, especially during the busy open enrollment period.

 

If you take no action, don’t worry. CGHC has pre-loaded the 2025 health plan that is equivalent to your 2024 CGHC health plan. This is the plan shown in your renewal packet, and it will renew unless you actively select a different plan.

 

If you need assistance with your renewal, you can call CGHC Member Services at 877.514.2442 or contact your agent.

Renew - How do I select a new plan if I do not want to accept the renewal plan offered?

To select a new CGHC plan, go to the Pay My Premium portal.

  • On the portal’s home page, select the click here to view your renewal offer.
  • Select Renew My Coverage and simply follow the on-screen instructions.
  • During the renewal process, you will be asked to confirm your plan selection. At this point you may select the CGHC plan that best fits your needs for the new plan year.

 

If you need assistance navigating the Pay My Premium portal, please contact our Member Services Team at 877.514.2442.

 

If you need assistance selecting a plan, please contact:

  • Your health insurance agent or
  • CGHC Renewal Support at 1-855-494-2667
Tax Credit - How do I know if I qualify?

During the enrollment or quoting process, you will be asked to provide your annual household income and the number of family members residing in your home. The Government will use the information you enter in determining your eligibility for the Advance Premium Tax Credit (APTC) or a Cost Sharing Reduction (CSR).

 

Things to note:

  • Your annual household income is based on the year for which you are enrolling in coverage.
  • All household members that file a federal tax return should be included in the household income amount that you provided, regardless of whether or not they enroll in the coverage or not.

 

For more info on how to estimate your annual household income, click here.

Tax Credit - Will it change from year to year?

The amount of your Advance Premium Tax Credit (APTC) or a Cost Sharing Reduction (CSR) from the federal government is always subject to change. Your credit or reduction amount will be impacted by changes in your income and/or household.

Keeping your information up to date with the Federal Health Insurance Marketplace (Exchange) ensures you receive the most cost savings for your coverage.   For details on reporting income and household changes, click here.

Health Plans - How do I view my plan options?

Visit the Individual and Family Plans 2025 page to view CGHC’s plan options.

  • Click on the images of the Benefit Plan Designs to see plans offered On Exchange and Off Exchange.
  • Select the corresponding Schedule of Benefits (SOB) that matches the plan design you are interested in, to view details of how benefits are paid.
  • Click  Summary of Benefits and Coverage (SBC), to access the 2025 plans.
Health Plans - How do I activate my coverage?

To activate your coverage, simply pay in full your first month’s premium for the new plan year. If you enroll between:

  • November 1 and December 15, your coverage will be effective on January 1.
  • December 16 and January 15, your coverage will be effective on February 1.
Plan Changes - How many times can I change my plan?

You may change plans as often as you like during the Open Enrollment Period, which runs from November 1 through January 15.

 

Please keep in mind:

  • Changes made to your plan may impact your premium and/or tax credit.
    • If a change impacts your premium, an adjustment may be needed even if the invoice has already been mailed.
  • The date a change is made determines when it will be effective.
    • If a member makes changes to coverage between:
      • November 1 and December 15, the effective date for the change will be January 1.
      • December 16 and January 15, the effective date for the change will be February 1.
  • When Open Enrollment ends on January 15, you will no longer be able to make changes to your plan – unless you qualify for a Special Enrollment Period.
Effective Date - When will my health insurance coverage begin?

The Open Enrollment Period for health insurance coverage begins November 1 and ends on January 15. If you enroll for coverage between:

  • November 1 and December 15, your health coverage begins on January 1.
  • December 16 and January 15, your health coverage begins on February 1.
  • After January 15, you will not be able to enroll in coverage for the 2025 plan year unless you qualify for a Special Enrollment Period.

 

Please note, your coverage will become active when we receive your first month’s payment in full.

Payment - When is my monthly premium payment due?

After your coverage is activated, you must pay your monthly premium responsibility by the 25th of each month prior to the next month’s coverage (for example, pay by February 25 for your March coverage).  CGHC offers several options for payment, including phone and online recurring payments. Click here to learn more about payment options.

 

If we do not receive your payment by the 25th of the month prior to the next month’s coverage, you will enter a grace period that allows you time to get caught up. You will remain in the grace period until you pay your total balance due, which is based on the date your payment is processed. If you do not pay the total balance due by the end of your grace period, your coverage will terminate, and you will be responsible for your health care and prescription costs. Grace periods vary by plan and are outlined in your Certificate of Coverage

EPO - What is an EPO network?

EPO stands for Exclusive Provider Organization.  This means that CGHC health plan members with individual and family plans will only have coverage for care received from in-network providers.  If you see an out-of-network provider, the services will not be covered, except for emergency care, urgent care outside of our service area, or when there are not any in-network providers that are qualified to treat your condition.*

 

*Starting 1/1/2025, if you are unable to find an in-network provider to treat your condition, your provider can request prior authorization for out-of-network services. If services are approved, a written approval letter will be issued to the member and provider.  If out-of-network services are denied, an in-network provider will be recommended.

 

 

Contact Info

If you need assistance with your enrollment, please contact

  • Your health insurance agent
  • CGHC Renewal Support at 855.494.2667

Submit your question(s) here!

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