Yes, we might be some of the only people who celebrate Open Enrollment like a major holiday—and we can’t help it. We love this time of year! But we get it: not everyone shares our enthusiasm. That’s why we created this friendly, comprehensive guide to help you navigate Open Enrollment 2026 with confidence. If this is your first time buying individual health insurance, consider this your new best friend.
Updated for 2026 Open Enrollment!
This guide is for employees offered an HRA by their employer, whether a Qualified Small Employer HRA (QSEHRA) or an Individual Coverage HRA (ICHRA), who want clear guidance for shopping for individual health insurance.
Every year, we hear the same questions from people navigating health coverage outside of a traditional group plan. Don’t worry—we’ve got you. Our platform will guide you step by step, helping you choose a plan that works for both you and your HRA for 2026.
Section 1: What is Open Enrollment?
Open Enrollment is the annual window when you can enroll in a health insurance plan. For 2026, it runs November 1 – January 15 in most states, with some exceptions:
- Extended deadlines: California, Nevada, New Jersey, New York, Rhode Island, and Washington, D.C. through January 31; Massachusetts through January 23.
- Coverage starting January 1, 2026: You must enroll by December 15, 2025, nationwide.
- Enroll after December 15 but before January 15? Coverage will generally start February 1, 2026.
Medicare enrollees (65+): Open Enrollment runs October 15 – December 7, for coverage starting January 1.
Why the dates are limited
Insurers limit enrollment to prevent adverse selection, which happens when sick people enroll while healthy people don’t, creating unbalanced risk for health plans.
Where to Buy Individual Insurance
During Open Enrollment, you can shop plans through the ACA Marketplace (Healthcare.gov) or your state’s exchange. Plans sold here are called “on-exchange” plans, eligible for subsidies like premium tax credits.
Some insurers also sell “off-exchange” plans directly through their websites. These plans are identical in coverage but do not qualify for subsidies.
Our Take Command platform lets you compare all available plans side by side—including off-exchange options—and highlights Easy Enroll plans, which simplify the sign-up process with our support.
Why Open Enrollment Matters
If your employer offers an HRA, Open Enrollment is the time to purchase a plan for 2026 coverage. You need a plan that works with your HRA, whether it’s an ICHRA or QSEHRA.
- ICHRA: Major medical plans (Bronze, Silver, Gold), Medicare (Part A+B or Part C), Catastrophic plans (under 30 or hardship), Student Health Insurance.
- QSEHRA: ACA-compliant major medical plans, government plans (Medicare, Medicaid, CHIP, TRICARE, VA), dental & vision, limited benefit plans (short-term, accident, indemnity).
Pro tip: If you see a plan with a metal tier (Bronze, Silver, Gold, Platinum), it’s usually HRA-compliant.
Section 2: How to Buy Individual Insurance
Shopping for insurance can feel overwhelming. Start by asking yourself:
- Do I want a lower premium or lower deductible?
- Do I need specific specialists or prescriptions?
- Do I anticipate ongoing medical needs this year (therapy, surgery, pregnancy)?
These factors largely drive your costs. Unpredictable events, like a cold or minor accident, shouldn’t dictate your plan choice.
Our platform lets you:
- Search by provider to see if they’re in-network
- Check if prescriptions are covered
- Compare all options side by side
Good news: Prices for the same plan are the same everywhere—Marketplace, state exchange, or broker.
Medicare and HRAs
Medicare plans (Parts A+B or C) can be reimbursed with your HRA.
We’ve partnered with Chapter, a white-glove service that simplifies Medicare Advantage and Supplemental enrollment, helping cover deductibles, co-pays, and coinsurance costs.
Medicare Open Enrollment: October 15 – December 7
Things to Avoid
- Don’t assume you’re ineligible for premium tax credits—you might qualify!
- Watch out for short-term or indemnity plans; they typically don’t qualify for HRAs.
- COBRA is often more expensive than alternatives. You could pay up to 102% of your previous plan.
Section 3: Premium Tax Credits (PTCs)
Premium Tax Credits are refundable credits that help eligible individuals cover health insurance premiums. Eligibility depends on:
- Household size and income
- Filing status (not Married Filing Separately)
- Marketplace enrollment
- No access to affordable employer coverage
QSEHRA & PTCs: Your employer contribution reduces your premium tax credit dollar-for-dollar.
ICHRA & PTCs: You cannot claim both. If you opt into ICHRA, you forfeit tax credits for that year. If you opt out, you may claim credits depending on affordability.
Section 4: Other FAQs
On-exchange vs. Off-exchange: On-exchange plans qualify for subsidies. Off-exchange plans don’t, but may still be HRA-compliant.
Metal Tiers:
- Bronze: Low coverage, higher out-of-pocket (~40% you, 60% insurer)
- Silver: Moderate coverage (~30% you, 70% insurer)
- Gold: Higher coverage (~20% you, 80% insurer)
- Platinum: Highest coverage (~10% you, 90% insurer)
Network types:
- HMO: Affordable, less flexible, referrals required
- PPO: Flexible, in- and out-of-network access
- EPO: Hybrid of HMO & PPO
- POS: Hybrid; referrals required but allows out-of-network access
Special Enrollment Periods: Big life events (marriage, baby, job change, HRA offer) allow you to enroll outside Open Enrollment.
Dental Coverage:
- Marketplace health plans may include dental.
- Otherwise, purchase separate dental plans—premium reimbursable through your HRA if eligible.
Next Steps
We’re thrilled to be part of your Open Enrollment journey!
- Log in to your Take Command portal.
- Compare plans side by side.
- Select a plan that fits your HRA and coverage needs.
- Cancel your old plan if switching, to avoid double billing.
Open Enrollment is your chance to take control of your health coverage and make the most of your HRA. We’re here to make the process simple, clear, and even a little fun.
Happy Open Enrollment 2026! 🎉