By Teresa McUsic,
THE SAVVY CONSUMER
The second open enrollment season for the health exchange under the Affordable Care Act is underway. The season lasts for three months, from Nov. 15 to Feb. 15, 2015.
This round is includes a better website to sign up, a shorter form to fill out, four more insurers in Texas including one big player, more help available—and higher tax penalties next year if you don’t have health insurance.
United Way of Tarrant County received the second highest grant in the nation from the Department of Health and Human Services--$4.6 million—to hire a network of 85 navigators across most of the state for education sessions and one-on-one enrollment. The non-profit plans to work with 500 organizations, including government entities, school districts, libraries, social service organizations and corporations. Navigators will make presentations at health fairs, community and workplace seminars, civic group meetings and other venues.
The plan is to reach 500,000 Texans, said Tim McKinney, president and CEO of the organization.
“We have as many people as the grant will allow,” said “Hopefully that will be enough.”
Overall, seven groups in the state received $9.7 million from HHS to help enroll Texans, said Stacey Pogue, senior policy analyst at the Center for Public Policy Priorities in Austin.
“A survey by Enroll America said that consumers who used in-person assistance were twice as likely to successfully enroll in the marketplace as those who attempted online without help,” Pogue said. “Without the help they hit roadblocks, whether it was technical or they didn’t understand a question. Even with in-person help a lot had to come back a second time.”
McKinney said face-to-face sessions to enroll with a navigator took from 45 minutes to two hours.
“Many were never insured, so we had to explain what a deductible and co-pay were,” he said.
Enroll America, a national non-profit focused on healthcare coverage, will also work in Texas with insurance agents, school districts and cities across the state to get the word out about the open enrollment period, said Mimi Garcia, Texas state director for the organization.
“We will have more boots on the ground to educate those who got coverage and those who didn’t,” she said. “There are still six million uninsured in Texas.”
For those 734,000 Texans who signed up for coverage for 2014 and are looking to renew next year some will see their insurance monthly premiums go down, while others will see small increases, said Pogue.
Those already enrolled should receive two notices in the coming weeks with any changes in their plan, including premiums, Pogue said. One notice will come from the marketplace, and another from the insurance company, she said.
“Most were eligible for auto enrollment for next year, but everyone should check to make sure their plan is the best fit by comparison shopping again,” Pogue said.
One reason for this is there will be four more insurance carriers offering plans on the exchange in Texas this time, Pogue said. More competition could have an impact on premiums and out-of-pocket costs.
Among the new insurers is UnitedHealthcare, the second largest insurers in the state behind Blue Cross Blue Shield of Texas. United stayed on the side lines during open enrollment in the Texas exchange last time, but has applied to sell plans on the marketplace in 24 states this time, including Texas.
While 84 percent of Texans who enrolled for coverage this year received a tax subsidy to pay for premiums and deductibles, Enroll America’s survey said the perception of affordability was the biggest barrier for the uninsured to sign up, Garcia said.
“It kept people from even trying,” she said. Enroll America has an easy-to-use calculator on its website, www.GetCoveredAmerica.org to show whether an individual will quality for a subsidy or not and an estimate of how much they would receive.
McKinney believes many Texans, especially Latinos, will be more aware of the healthcare exchanges this time. Hispanics made up one-third of those who enrolled last time, the second largest group behind whites in the state.
“We think word of mouth, especially in the Hispanic community, will help us be more informative than last year,” he said. “Hispanic’s are very family-oriented and will share a positive experience. It will reach out in fingers.”
Garcia said the impact of the tax penalty caused a surge in registration in the last month of the previous open enrollment. For those who don’t enroll for 2015, the penalty is even higher.
If you did not have health insurance this year, there is a federal tax penalty of the higher of $95 per person or 1 percent of taxable income. For those without health insurance in 2015, the penalty jumps to $326 per person or 2 percent. In 2016, the penalty goes to $695 or 2.5 percent.
While open enrollment is on until Feb. 15, 2015, don’t wait until the end. Those who want coverage starting Jan. 1, 2015, must apply by Dec. 15.
Teresa McUsic’s column appears Saturdays in the Fort Worth Star-Telegram. She can be reached at TMcUsic@SavvyConsumer.net
|By the Numbers
|Health Exchange Enrollment So Far
|Total signed up
|Total signed up with tax credits
|Percent of uninsured eligible to enroll
Source: Center for Public Policy Priorities
Help for Health Exchange Sign Up
* Navigators. The Consumer Health Insurance Marketplace Enrollment Services (CHIMES) is holding a number of information sessions in churches, libraries, agencies and non-profits in Tarrant County throughout the enrollment period. For more information, go to www.unitedwaytarrant.org/CHIMES. United Way of Tarrant County has navigators for one-on-one sessions in English, Spanish and Vietnamese either via phone or in person. To schedule an appointment, call 817.258.8188 or email email@example.com
* Hot Line. The federal toll-free call center is 800-318-2596 or 855-889-4325 (for hearing impaired) for signing up via phone.
* Online. To enroll yourself, the federal government has an online website to shop and purchase health insurance at www.healthcare.gov or for Spanish speakers, www.cuidadodesalud.gov. To find locale help online and a cost calculator, go to www.GetCoveredAmerica.org.
* Agents. Insurance agents can sign people up over the phone or make a home visit. The Texas Association of Health Underwriters has a directory that includes 600 local health insurance agent in DFW at www.tahu.org. Agents for Action, a statewide partnership of insurance agents, which offer help in Spanish and English locally at Affordable Health Insurance Agency in Grand Prairie at 888.803.3537.