Navigating the new Health Care Exchange

• SVT Clinic designated the federal contract

By Naomi Klouda
Homer Tribune
Phones rang briskly at the Seldovia Village Tribal Health Clinic each day last week, often holding a panicked consumer on the other end of the telephone line.
“How do I sign up for health insurance? I need to do it today,” one person told Seldovia Village Tribe Medical Clinic Emiley Sue Faris.
“We’ve had a lot of calls. A lot of interest and we are here to help. I told her, ‘be patient. You have plenty of time,’” Faris said.
Open enrollment runs from Oct. 1 to March 31, 2014.
The uninsured in the Homer area didn’t waste time. Once enrollment for the Health Care Exchange opened last Monday, crowds of local people reached for the phone and logged on line. The SVT Clinic was designated the federal contract to receive training and funding to supply the answers.
Faris, the outreach enrollment coordinator, is assisted by two outreach eligibility specialists.
Politically charged information made people scared or anxious, Faris said. To make tensions even more stretched, the online healthcare.gov website used for calculating insurance premiums and eligibility credits was overloaded.

Chart your own health costs Alaskan’s calculation for subsidies are based on income guidelines. Find your income level and family size below. The premium amount is based the formula: Premium Price – Government Subsidy = Maximum monthly cost. Alaskans pay a maximum deductible of $4,500 per individual or $9,000 deductible per family.  If your income is above 400 percent of the poverty level, the full premium price applies. All uninsured individuals may enroll between now and Dec. 15 for Jan. 1 insurance coverage. Information source: Northrim Benefits Group

Chart your own health costs
Alaskan’s calculation for subsidies are based on income guidelines. Find your income level and family size below. The premium amount is based the formula:
Premium Price – Government Subsidy = Maximum monthly cost.
Alaskans pay a maximum deductible of $4,500 per individual or $9,000 deductible per family.
If your income is above 400 percent of the poverty level, the full premium price applies. All uninsured individuals may enroll between now and Dec. 15 for Jan. 1 insurance coverage. Information source: Northrim Benefits Group

“We weren’t able to log on, but we told people we have the paperwork here, and we answered their questions,” Faris said.
Medicaid is expanding its rules, making for a complicated task of bringing the public up to speed. Under new guidelines, many of those inquiring on the new Health Mart Exchange will be eligible for Medicaid.
“But it’s all for the good. It’s going to make the people who serve the community better at what they do. The convenience to the public is going to be major,” she added.
The biggest point to get across: the price of insurance isn’t the only number to look at. After subsidies, premiums are substantially reduced. Deductibles also come with a subsidy.
“It’s important for them to know is there will be exemptions,” Faris said. “Credits will help pay for the insurance.”
The Kaiser Foundation supplies a calculator for general public use. A man in his 50s who earns a season income of $25,000 a year, for example, would pay about $50 a month after exemptions. A deductible also would be subsided – or that person may be eligible for Medicaid under the new rules, Faris said.
“It is all based on income and the number in your family. Single people are panicked, but they shouldn’t be because when they shop around and look at it, they will be able to see where they need to be,” Faris said.
Any individual in the 100 to 400 percent federal poverty range is eligible for a government subsidy to offset insurance costs. That ranges from $14,350 in income for one person to $200,000 income per year for a family of eight. (See chart)
If an insurance plan is in place by Dec. 15, insurance begins Jan. 1.
The SVT is taking scheduled appointments to do one-on-one assistance. Call 226-2228 for help.

Going it alone
Consumers can click on EnrollAlaska or Healthcare.gov and ask for a price quote. Just as you would for auto insurance, a few basic questions, once answered, gives all the information needed for a calculation. Alaskans are given price quotes on monthly premiums plus deductions.
But don’t stop there, advises SVT’s Monica Monica Anderson, an outreach and enrollment specialist. The Kaiser Foundation supplies a calculation tool at Kff.org/interactive/subsidy-calculator  that generates the information on subsidies.
“Play around on this interactive calculator, inputting income, family number,” Anderson said.
If this second step isn’t taken, consumers will be misled into believing they will be responsible for bigger premiums.

More help on the way
The large umbrella organization over the Enroll Alaska Health Exchange is Northrim Benefits Group. They will be organizing events in the weeks ahead for residents from Ninilchik to Nanwalek to meet in Homer, said Tyann Boling, the chief operation officer.
“We will be holding events in Homer soon, working with organizations there,” Boling said. Staff will be on hand to provide assistance with enrollment. The group also will set up appointments at Central Peninsula Hospital and other key locations in Kenai.
South Peninsula Hospital didn’t have space for Northrim to set up enrollment tables, Boling said. “Unfortunately, we were not able to put that together, but we have outreach planned in other ways to support the communities on the southern Kenai Peninsula.”
Northrim is seeking licensed agents to join in its efforts to enroll Alaskans. “We are looking for licensed agents and would be more than happy to have them join our team and provide resources,” Boling said.
Northrim’s own experience comes in supplying corporate group insurance for the past 30 years in Alaska. That company was designated for the federal Enroll Alaska program. Alaska did not set up its own state enrollment program, after Gov. Sean Parnell declined money to do so.
Boling expressed enthusiasm about the possibilities for Alaska’s estimated 66,000 uninsured or 20.5 percent of the population.
“There is an immediate tax credit applied to the premium’s amount. This government subsidy will help many Alaskans across the state,” Boling  said. “It’s a great benefit. That’s why it is important to get them enrolled and into an insurance policy that’s right for them.”
There are only two insurance companies offered to Alaskans: Blue Cross and Moto. But there are also across-state-line possibilities for students attending college Outside and other reasons.

Employer’s role and mandates
Misinformation abounds about the Affordable Care Act. One key myth is how it impacts small business employers. There is no mandate that a small business owner must supply insurance for employees, Boling said.
If a business wants to consider as an option a group rate, that’s available, Boling said.
“Only individuals that do not have insurance must enroll,” she said.
But there are many exceptions as well, SVT’s Faris points out. Those who do not have to enter the insurance exchange are those already insured, Medicaid recipients, Alaska Natives, American Indians, and those who are eligible for a hardship exemption. The hardship exemption comes in when an estimated premium exceeds 8 percent of your annual income.

More information is available at 1-855-385-5550  or visit at www.enrolling Alaska.com

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Posted by on Oct 9th, 2013 and filed under Headline News. You can follow any responses to this entry through the RSS 2.0. Both comments and pings are currently closed.

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