Enrollment is underway in Delaware for the Health Insurance Marketplace, sometimes known as Obamacare.
Enhanced federal subsidies, which began earlier this year under the Biden administration, will continue for 2022. The subsidies have helped to reduce consumer costs by as much as 40%.
The marketplace is designed for those who are between jobs, the self employed or those who are not covered by a group health plan.
The marketplace’s ninth open enrollment period started on Nov. 1 and ends on Jan 15, 2022, at www.HealthCare.gov. Consumers can renew existing coverage or sign up for a new plan. Coverage for enrollees who sign up by Dec. 15 and pay their first month’s premium will take effect on Jan. 1, 2022.
Individuals who don’t act by Jan. 15, 2022, cannot get coverage for 2022 unless they qualify for a Special Enrollment Period based on circumstances such as a loss of qualifying health coverage, change of income, becoming a parent, or other qualifying factors.
Monthly premiums for 2022 plans in Delaware will be 3% higher on average than the 2021 plans. Highmark Blue Cross Blue Shield Delaware is the sole health insurer offering Delaware’s Health Insurance Marketplace plans. Enrollees will choose one of 13 Highmark plans, or they will be re-enrolled automatically in a plan similar to their current one.
This year’s single-digit increase in premiums follows decreases in the last two enrollment years, totaling more than 19%. Those base premium reductions and the stability of Delaware’s Health Insurance Marketplace reflect continued federal approval of Delaware’s reinsurance program.
The program has lowered health insurance premiums for plans sold in the individual insurance market by partially reimbursing insurers for high-cost health care claims through a fund that uses a mix of federal funding and assessments collected by the Delaware Department of Insurance from health insurance carriers. Because the insurers’ claims costs are lower, the insurers can reduce the cost of premiums or limit increases.
In addition, American Rescue Plan Act funds have been used to increase tax credits and expand subsidies further into the middle class. For instance, a family of four (both parents in their 40s) making $50,000 are eligible for a credit of roughly $16,500, compared with $14,300 previously. A majority of Delaware marketplace enrollees will be eligible for financial assistance, which can help reduce the cost of monthly premiums and/or deductibles, and lower out-of-pocket health care costs.
Through last year’s Open Enrollment and a Special Enrollment Period held earlier this year for people who lost coverage because of the pandemic, about 30,000 Delawareans now have coverage through Delaware’s Health Insurance Marketplace.
Federal tax credits are available for those whose household income is between 138% and 400% of the Federal Poverty Level.
For 2022 coverage, the figure is between $17,775 and $51,520 for an individual, or between $36,570 and $106,000 for a family of four. For coverage in 2021, about 81% of enrollees in Delaware were eligible for tax credits, which help reduce the cost of the monthly premium.
Plans on the marketplace are spread among metal-level categories – bronze, silver, gold, platinum, and catastrophic – and are based on how enrollees choose to split the costs of care with their insurance company.
For 2022, Highmark will offer 13 plans for individuals – four gold plans, three silver, three bronze, two platinum, and one catastrophic. In addition, two dental insurers – Delta Dental of Delaware, Inc. and Dominion Dental Services, Inc. – will offer a total of 12 stand-alone dental plans on the marketplace.
State-licensed insurance agents and brokers are also available to help individuals re-enroll and to help employers update their coverage at no extra charge.
For more information, go to www.ChooseHealthDE.com. You can enroll in marketplace coverage at HealthCare.gov or by calling 1 (800) 318-2596 (TTY: 1-855-889-4325). According to the U.S. Department of Health and Human Services (HHS):
- Delaware’s total open enrollment for 2021 (25,320) increased about 5.6% over the previous year.
- About 81% of Delaware’s marketplace enrollees receive financial assistance to help pay their monthly premiums and/or deductibles and co-pays.
- The overall average monthly premium in Delaware is $675, with the average premium reduced to $211 per month after tax credit. For the 81% of Delawareans who receive financial assistance, the average premium after tax credit is $119 per month.
- Among the 25,320 people who signed up during last year’s open enrollment, about 80% were re-enrollees and 20% were new enrollees.
- About 74% of Delaware’s enrollees signed up during the final three weeks of open enrollment in 2020.
- Both the Health Insurance Marketplace and the Medicaid expansion have helped to reduce Delaware’s uninsured rate, decreasing from 10% in 2008 to 6.6% in 2019, according to the Census Bureau. That decline includes Delawareans who could not get coverage before the Affordable Care Act because of pre-existing conditions.