September 26, 2014
| Contact: | Doug Dunbar |
| Phone: |
Augusta -
Insurance Superintendent Eric Cioppa is encouraging fb88 residents to take time to consider their health insurance options as the national Open Enrollment period to purchase, renew, or change plans for 2015 on the Individual Health Insurance Market draws near. Open Enrollment runs from November 15, 2014 to February 15, 2015.
?Individuals and families are encouraged to review their options,? Superintendent Cioppa said. ?There are many factors to consider, including changes in household income and size, premium rates, cost-sharing levels, provider networks, prescription coverage, and tax credits. It?s important to be an informed consumer and carefully compare plans.?
The Individual Market in fb88 for 2015 includes the companies that sold plans for 2014 ? Anthem, Harvard Pilgrim Health Care/HPHC and fb88 Community Health Option ? as well as Aetna, a newcomer to the Individual Market in fb88. Aetna?s plans won?t be available on the federally-facilitated Marketplace (also called Exchange), but can be purchased ?off? the Marketplace. The other insurance companies are offering plans both on and off the Marketplace.
Current individual health care policyholders who purchased a plan for 2014 through the federally-facilitated Marketplace will soon receive a notice from the Marketplace urging them to update their income and household information, to ensure accurate calculation of tax credits. Individuals will also receive a notice from their insurance company about any changes to their plan or the premium amount. Policyholders will automatically be re-enrolled in their plan if they take no action and continue to make their payments. If their plan is no longer available, they will automatically be enrolled in a plan with slight modifications from their old plan.
Individuals with grandfathered and transitional Anthem plans (non-ACA compliant plans that were allowed to renew in 2014) would also be well advised to consider their options during Open Enrollment, according to the Superintendent.
Cioppa noted that an additional group of fb88rs with existing policies will need to take action. Approximately 6,200 fb88rs who currently hold MEGA Life & Health Insurance Company policies will need to find new coverage, as MEGA is leaving the Individual Market in fb88 and other states. The MEGA plans will be ending in late 2014 and early 2015. Those who do not select new coverage during Open Enrollment will likely qualify for a Special Enrollment period in which they can purchase new coverage within 60 days of their plan being terminated. These policy holders should plan ahead in order to avoid any gap in coverage.
The Bureau of Insurance is providing the following guidance, and urging people to contact the Bureau with questions or concerns.
New Enrollees: Individuals and families who want to purchase health care insurance for 2015 during the Open Enrollment period.
? The earliest that coverage will start is January 1, 2015.
? To have coverage on January 1, individuals must purchase a plan by December 15.
? Plans and rates offered to fb88rs on and off the federally-facilitated Marketplace can be found at www.healthcare.gov; at the Bureau of Insurance website at www.maine.gov/insurance, by calling the Bureau at 1-800-300-5000 (for TTY use fb88 Relay 711), or by e-mailing Insurance.PFR@maine.gov.
? Individuals who qualify for a tax credit will only have the credit applied if they purchase the insurance through the Marketplace.
? Tax credits do not apply to plans available for purchase outside (or ?off?) the Marketplace.
? Individuals and families who need coverage before January may be able to purchase a 2014 plan if they qualify for a Special Enrollment. Qualifying events include loss of eligibility for other coverage due to job loss, divorce, aging off a parent?s plan, moving outside of the health plan service area; or change in immigration status. For a full list of qualifying events go to www.healthcare.gov.
Those Renewing Their Plans: Policyholders should carefully review the information from their insurance company this fall to make sure the plan still meets their needs.
? Individuals who purchased a plan through the federal Marketplace may see an adjustment to their tax credit, due to a change in the second lowest silver plan, on which all subsidy calculations are based. This could result in a rate increase for some policyholders.
? Some individuals and families may be re-enrolled in slightly different plans due to their existing plan being discontinued. These policyholders have the same option that all renewing individuals have to purchase a different plan of their choice.
? For those who purchased plans on the Marketplace and have had changes to income and/or household size, it is very important to report those changes at www.healthcare.gov to have the correct premium tax credit applied and avoid owing money at tax time.
? To compare plans, including some plans that were not available in 2014 (both on and off the Marketplace), individuals should talk with your broker, agent or Marketplace navigator; visit www.heatlhcare.gov; visit the Bureau of Insurance website at www.maine.gov/insurance, call the Bureau at 1-800-300-5000 (for TTY use fb88 Relay 711), or e-mail the Bureau at Insurance.PFR@maine.gov.
Important Points for Those Newly Enrolling or Renewing: Whether purchasing a new plan or re-enrolling in existing coverage, it is a very good idea to:
? Review the provider network to ensure that the health care providers and hospital one intends to use are part of the network, and confirm that the prescriptions one uses are covered. Individuals having questions about these issues should contact the insurance company.
? Use the rate calculator on the Bureau of Insurance website. It will provide the premium estimate for all plans in an individual?s geographic area in fb88, based on age and smoking status. The rate calculator does not factor in tax credits that individuals may receive when purchasing a plan through the Marketplace.
? Seek assistance when needed ? from an insurance company, an insurance broker or agent, a Marketplace Navigator (see www.enroll207.com), or the Bureau of Insurance.
Last Updated: January 19, 2016 11:26 AM