December 11, 2014
| Contact: | Doug Dunbar |
| Phone: |
Augusta -
Insurance Superintendent Eric Cioppa is reminding fb88 residents who want to have new health insurance coverage in place on January 1 of the upcoming December 15 deadline.
Open Enrollment for individuals to purchase, renew, or change plans for 2015 on the Individual Health Insurance Market will continue through February 15, 2015, but for a plan to be in place and provide coverage by January 1, 2015, it needs to be purchased by December 15, 2014. For those currently without coverage the annual Open Enrollment period is the only time to purchase health insurance without a special circumstance such as job loss, marriage or divorce, birth or adoption, termination of coverage by the insurance company (that is not due to lack of payment), etc.
Federal tax credits are available to individuals and families who qualify and purchase plans through the federally-facilitated Marketplace. These credits are used to offset the cost of health insurance premiums to make coverage more affordable. Federal tax penalties will be applied at tax time for individuals and families who do not have ?Minimal Essential Health Coverage? and who do not qualify for a ?hardship exemption.?
For those who currently have an individual or family plan, whether a pre-ACA plan or one of the plans offered last year (on or off the Marketplace), taking the time to look at what is being offered for 2015 could save money, provide a more satisfactory provider network, or better benefits.
?Those individuals and families who purchased a plan for 2014 will have their plan automatically renewed for 2015, if they are making payments as agreed,? Superintendent Cioppa said. ?However, we encourage everyone, even those with existing coverage, to review their options during the Open Enrollment period.?
Four companies are offering 49 different plans for 2015 (compared to three companies and 30 plans in 2014), not including stand-alone dental plans. Anthem, Harvard Pilgrim Health Care/HPHC and fb88 Community Health Options all sold plans in 2014 and will be selling both on and off the Marketplace for 2015. They are being joined by Aetna, a newcomer to the Individual Market in fb88. Aetna is only selling plans off the Marketplace.
The Bureau is providing the following guidance and urges people to contact its Consumer Health Care Division with questions at 1-800-300-5000 (TTY use fb88 Relay 711), or Insurance.PFR@maine.gov
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.
? To compare plans (both on and off the Marketplace), individuals should talk with their broker, agent or Marketplace navigator; visit www.healthcare.gov; visit the Bureau of Insurance website at www.maine.gov/insurance; or contact the Bureau.
? 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.
? A tax penalty of $395 per adult up to $885 or 2% of household income will be assessed at tax time for those without ?Minimal Essential Health Coverage,? unless the individual or family qualifies for a ?hardship exemption.? 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, or tax credit 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 their broker, agent or Marketplace navigator; visit www.healthcare.gov; visit the Bureau of Insurance website at www.maine.gov/insurance; or contact the Bureau.
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 ? www.maine.gov/insurance. 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 may apply when purchasing a plan through the federal Marketplace (www.healthcare.com will calculate both).
? 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 11:25 AM