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What health reform means for the people of Illinois

A blog by IllinoisHealthMatters.org

Saturday, November 23, 2013

DOI Moves to Allow Consumers to Continue Current Coverage into 2014

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                        The Official Health Marketplace

The Illinois Department of Insurance (DOI) announced on November 22 that it will follow President Obama’s November 14 recommendation and allow insurance companies to renew a number of health plans in the individual and small group markets that do not meet certain Affordable Care Act (ACA) requirements without being penalized. Illinois joins Florida, North Carolina, Ohio, Kentucky, Kansas, Oregon, South Carolina, Colorado, Hawaii and Texas in giving insurance companies the choice to renew existing health insurance policies with current policyholders.

“DOI came to this decision based on the concerns raised by Illinois consumers and the guidance from the U.S. Department of Health and Human Services,” Andrew Boron, Director of the Illinois Department of Insurance said. “Allowing companies to renew current plans gives consumers more time to evaluate their options and will provide a smoother transition into the health care coverage system envisioned by the ACA.”

DOI will immediately work with insurance companies who choose to extend the terminated or cancelled coverage to quickly renew such policies. In step with President Obama’s announcement, policies in effect on Oct. 1, 2013, in the individual or small group market, can be renewed for a policy year starting between Jan. 1, 2014, and Oct. 1, 2014.

According to notifications received by DOI, approximately 185,340 people in Illinois have been advised by insurers so far in 2013 that their coverage has been cancelled or terminated. DOI’s most recent data indicate that more than 476,000 Illinois residents were insured by private individual policies in 2012.

Today’s announcement was made on the same day that federal authorities pushed back the deadline for enrolling in a plan that begins on Jan. 1, from Dec. 15 to Dec. 23. The change gives people eight additional days in which to consider their options.

For Illinois consumers, the ability to renew plans will depend on their insurance company’s decision of whether or not to exercise this option. Consumers should contact their local insurance agent to discuss what options are available to them.

In addition, according to the federal government, any insurance company choosing to renew a non-compliant plan in 2014 should notify consumers that they can purchase coverage through the Health Insurance Marketplace where they may qualify for federal financial assistance, which may include premium tax credits for small employers and other subsidies for individual consumers. This notice should also advise consumers about the protections under the ACA they are foregoing by renewing their current plans including certain Essential Health Benefits that may not be offered through existing plans. Such protections will be required in plans being sold in the Health Insurance Marketplace.

Insurance companies will not be permitted to sell any new plans after December 31, 2013 that do not meet ACA standards. Consumers seeking healthcare coverage should continue to visit http://getcoveredillinois.gov to learn about new health insurance options available through the Marketplace. Those who may consider keeping their current policy should compare it with new plans offered through the Marketplace which cover more benefits, sometimes at a lower cost. DOI is also recommending consumers that have questions regarding differences between a continuation of their current coverage and benefits afforded to them through a plan on the Health Insurance Marketplace to call DOI’s Office of Consumer Health Information at (877) 527-9431.

The following insurers have received approval to offer coverage through the Illinois Health Insurance Marketplace:

Aetna Life Insurance Company
Coventry Health and Life Insurance Company
Coventry Health Care of Illinois, Inc.
Health Alliance Medical Plans, Inc.
Health Care Service Corporation, a Mutual Legal Reserve Company (Blue Cross)
Humana Health Plan, Inc.
Humana Insurance Company
Land of Lincoln Mutual Health Insurance Company

“Making certain that Illinois residents have access to quality affordable health care remains one of our top priorities,” continued Boron. “Today’s actions reinforce our commitment to a culture of coverage.”

Republished from Get Covered Illinois News

Thursday, November 7, 2013

An Illinois Navigator's Experience Finding Lower Premiums in the Marketplace

I decided I might as well enroll myself with a Qualified Health Plan on the Marketplace before I sat down as an In Person Counselor (with a client) so I tried for a few days right after Oct. 1.

Since the site was so slow, I decided to wait until some of the excitement wore off and tried again in mid-October. I sat down after dinner and put in an hour on the computer. I quickly verified my identity, similar to the online process for requesting your free credit report. I answered simple questions about what streets I have lived on, former cities I lived in, etc. They were all multiple choice questions, and I got them all right!

Then I was able to compare the plans for my county and sort them based on certain features: metal, HSA eligible, out-of-pocket costs, etc. At that point there are fewer plans to choose from and I checked off the "compare box" on three that I thought seemed to be a good fit. After looking at the plans, side by side I was able to click on a link with each that took me to the website for each plan so I could do a provider search. I entered my current doctor and to see if my doctor was in-network. This made it pretty easy for me to decide. The pages did load slowly so I folded laundry while they loaded.

Once I enrolled in health coverage, I had to decide to elect or not to elect to access dental. I went through the same process with the dental coverage, but did find that the links did not work for all the dental plans. I eventually decided on a plan and enrolled. Then I put the laundry away while it loaded and waited.

At the end, I got the page where it said my application was complete. I printed out the page along with my application ID# and am excited to let people know that my premiums are going down!

I self-pay for insurance now and will still do so in 2014. I currently pay just over $340 a month for health and dental. Starting in January, I will only pay $185.10 for health and dental. I make too much money for any tax subsidy, so even without assistance I am seeing a huge benefit. I still get to see the same doctor and dentist that I have had since I was a kid and really cannot complain too much. Buying insurance before privately took more time as I would have to research and deal with the insurance brokers and then the underwriters questioning of any of my possible health issues.

I look forward to helping my clients find affordable options on the Marketplace, too.

Joann Boblick
Certified In Person Counselor
La Grange, IL

Tuesday, November 5, 2013

Clearing up the Facts

There has been a lot of confusion about some recent notices to consumers from insurance companies that sell coverage in the individual insurance market, and I’d like to clear up the facts.

Today, more than 3 out of every 4 Americans get insurance from an employer, Medicare, Medicaid, or the Veterans Benefits Administration. Americans who purchase insurance on their own, however, generally buy coverage in the individual insurance market.

Before the Affordable Care Act, coverage in the individual market often was unaffordable, had high co-pays or deductibles, or lacked basic benefits like maternity care, mental health services, and prescription drug coverage. These plans also had high turnover rates, and often were not renewed at the end of a plan year. One study showed that more than half of enrollees in the individual market left their plan within a year.

The health care law is creating new protections for people in the individual market, as well as strengthening employer-based coverage. In the Health Insurance Marketplace, consumers will no longer be charged more because of gender or a pre-existing condition, recommended preventive services will be covered with no additional out of pocket cost, there will be caps on out of pocket costs, and plans will have to offer a basic package of 10 categories of essential health benefits.

Some insurance companies that sell products in the individual market are making changes to their plans. Plans that were in place before the Affordable Care Act passed, and that essentially have not changed - that is benefits have not been cut or additional costs imposed on consumers - are exempt or “grandfathered” out of these basic requirements that ensure quality coverage. Those grandfathered plans can stay the same. Nothing has changed this fact, and that coverage can continue into 2014, so long as both the insurance company and the consumer agree that it will continue.

Some of less than 5 percent of Americans who currently get insurance on the individual insurance market have recently received notices from their insurance companies suggesting their plans may no longer exist. These Americans have a choice – they can choose a plan being offered by their insurer, or they can shop for coverage in the Marketplace. As insurers have made clear – they aren’t dropping consumers; they’re improving their coverage options, often offering plans that are more affordable.

Today, consumers have a choice of an average of 53 qualified health plans in the states where the federal government runs the Marketplace, including those in which it does so in partnership with states. Nearly all consumers live in states with average premiums below earlier estimates. Moreover, half of the people in the individual market today qualify for lower costs on monthly premiums when signing up for coverage through the Marketplace.

While the product is good, there is no denying the online experience on HealthCare.gov must be improved. We will not stop improving the site until every American that wants it has access to quality, affordable coverage.

Importantly, while the team is improving the site, we have opened up new pathways for consumers to apply for coverage through the Marketplace. There are four basic ways to apply for coverage. Sign up by December 15 for coverage that starts January 1, 2014. Enrollment stays open until March 31.

By Kathleen Sebelius, Secretary of Health and Human Services
October 30, 2013 on the HHS.gov blog