Delaware will see its second sign-up period under the Affordable Ace beginning on Saturday.
Delaware also joins a handful of states that offer the online SHOP Marketplace (Small Business Health Options) for businesses with 50 or fewer full-time-equivalent employees. Businesses with fewer than 25 employees may qualify for a Small Business Health Care Tax Credt, worth up to 50 percent of premium costs.
Smaller employers that continued to offer coverage frequently reported sharply higher premiums, with employees seeing higher co-pays and deductibles. Sign-up periods typically work on a calendar year, although other companies use March or June dates.
Despite sign-up snafus in the early going last year and an overly ambitious projection of 35,000 sign-ups, Delaware did end up with 14,300 enrolled under the first year of “Obamacare.”
A kick off event was held on Friday that featured state Health and Social Services Secretary Rita Landgraf, state Insurance Commissioner Karen Weldin Stewart, U.S. Rep, John Carney and U.S. Sen. Tom Carper. The event also featured people who benefitted from signing up for coverage that has been the target of repeated Republican attempts to overturn the legislation in Congress.
Open enrollment for health coverage in 2015 runs from Nov. 15 through Feb. 15 on HealthCare.gov. Individuals must sign up by Dec. 15 for coverage to be effective Jan. 1. Policies for all current enrollees expire on Dec. 31.
There have been reports of “sticker shock” over premium increases in cases where consumers were allowed to keep their old coverage for another year in a last minute change. Older plans typically had many restrictions, but were popular for cost reasons if the individual did not end up with an expensive illness.
Still, DHSS pointed to improvements over a year ago that include:
• More choice: People who are re-enrolling or enrolling for the first time 23 plans to choose from, rather than the vs. 19 in 2014. Highmark Blue Cross Blue Shield, Aetna Health, and Aetna Life Insurance administer the plans.
• A streamlined HealthCare.gov sign up process
•Health benefits that include coverage of pre-existing conditions, outpatient care, emergency services, hospitalization, prescription drugs, mental health and substance-use disorder services, lab services, pediatric services and more.
•Federal financial assistance that in 2014 helped to lower the cost of coverage for eight out of 10 Delawareans.
For those not wishing to sign up, a higher penalty will be assessed. Those who are not exempt and do not buy insurance for 2015 will pay $325 per adult (plus $162.50 for each child not covered) or 2 percent of their household income, whichever is higher.
However in some cases, the increase in rates was so great that some people will go without insurance and instead pay the penalty.
•A redesigned ChooseHealthDE.com website that includes an interactive tool for consumers to find in-person assistance from marketplace guides, a penalty calculator that will give a rough estimate of what you will pay if you do not have health insurance in 2015, and a link to certified agents and brokers.
All plans purchased through the marketplace anytime in 2014 expire Dec. 31. Those buying a health insurance plan this year can renew their current plan or enroll in a different plan for 2015, according to DHSS.
“We strongly encourage consumers to make sure their current plan still meets their needs and to see if they might be eligible for lower costs,” Landgraf said.
While consumers in some states will face double-digit premium increases in 2015, Insurance Commissioner Stewart reported better news in the First State. “I negotiated with Highmark/Blue Cross Blue Shield to keep their rate increases at 3.99 percent, down from a requested 5 percent. And Aetna actually submitted a request which reflected a small reduction in rates. So sticker shock should be kept to a minimum for Delawareans who buy marketplace plans in 2015.”
In addition to the Health Insurance Marketplace, some residents might be eligible for coverage though Delaware’s expanded Medicaid program, which continues year-round.
In addition to www.ChooseHealthDE.com, consumers can call 1 (800) 318-2596, TTY: 1 (855) 889-4325. Individuals can enroll in marketplace coverage directly at www.HealthCare.gov or through an agent or broker.
