Ensuring all employees get coverage

With some exceptions, the Affordable Care Act (ACA) extends guaranteed availability and renewability protections to individuals and employers, so they are able to obtain and maintain health insurance coverage.

The ACA’s Guaranteed Issue provision requires health plans permit enrollment regardless of health status, age, gender, or other factors that might predict the use of health services. 

The only exceptions to guaranteed availability are:

  1. nonpayment 
  2. fraud 
  3. violations of participation/contribution requirements (group market only) 
  4. movement outside of service area 
  5. loss of association membership (if applicable)
The Guaranteed Renewal provision of the ACA ensures that health plans and carriers must offer to renew coverage as long as the premiums continue to be paid.