- On Tuesday the open enrollment period for the federal facilitated marketplace for healthcare coverage began.
The marketplace, designed for the Affordable Care Act (ACA), deemed Obamacare, allows individuals who don't have health insurance, to “shop for and compare options for affordable coverage.”
Open enrollment runs until March 31, 2014.
With Tuesday's launch of the marketplace, the website, healthcare.gov, was full of activity. Health insurance companies like Blue Cross of Northeastern Pennsylvania were also kept busy helping consumers with any questions or concerns they may have had.
“Open enrollment began and a number of people weren't successful,” said Suzanne Fletcher, vice president of finance and administrative services and the program leader for health care reform for Blue Cross of NEPA. “We expected that it wouldn't be smooth sailing on day one with it being a new system.”
She said they had “adequate staff” available to help potential consumers. Blue Cross members also said that “six out of 10” people in Northeast Pennsylvania are carrying a card from Blue Cross, so people know they are a “good source” for information.
“We've seen similar things happen across the country with people having trouble,” stated Paul Holdren, senior vice president and chief dales and marketing officer for Blue Cross of NEPA. “It was an enormous undertaking and the system wasn't prepared to handle it.”
The Associated Press reported that “high demand and technical glitches led to long delays” as well.
“It's early in the game,” said Fletcher. “We know it's being used but we don't have enough information yet to see how well it's working. We don't want to add any confusion to consumers. We were prepared ahead of time.”
“We're comfortable with it,” said Holdren. “It's as straightforward as a highly complicated system can be.”
Blue Cross was even prepared with their own website, where they are offering several plans for consumers.
“It's strategy but it's also requirement,” explained Holdren. “We had to determine what benefits we would offer in each medal level we have that would fit with federal regulations. It was our desire to have a range of products that met the requirements, but also allowed options. It's a broad network.”
Fletcher and Holdren agreed that there has been confusion about open enrollment and what it means.
“Some people thought that the only date they could sign up was October 1,” said Fletcher. “But you have until March 31, 2014 for open enrollment.”
Another misconception was when coverage would start.
Page 2 of 3 - “Some thought it would start immediately,” stated Holdren.
They explained that coverage will start based on when you sign up. For example, if you sign up before Dec. 15, coverage will begin Jan. 1, 2014.
“Depending on when people sign up, coverage can begin between January 1 and April,” said Fletcher.
Both Fletcher and Holdren also talked about a special enrollment period for people with a life event.
The following list, provided by Blue Cross of NEPA, are things that can qualify as a life event for the special enrollment period:
• You or your dependents lose group coverage because of termination of employment (except for gross misconduct) or reduction in hours.
• You or your dependent lose group coverage because of the death of the enrollee.
• You or your dependents lose group coverage because of a divorce or legal separation.
• Your dependent loses group coverage because of loss of eligibility as a dependent child.
• You or your dependents lose group coverage because the group enrollee's initial enrollment for Medicare.
• For a retired enrollee, spouse and other dependents, if you lose group coverage because of bankruptcy filing by a former employer, under Title XI, United States Code, on or after July 1, 1986.
You must enroll yourself and any eligible dependents within 60 days if any of these events occur:
• You or any of your eligible dependents lose minimum essential coverage (failure to pay premium or a rescission of coverage allowed under federal law do not qualify as a loss of minimum essential coverage).
• Newly acquired dependents through marriage, birth, adoption, or placement for adoption.
• You become a citizen, national or lawfully present individual in the U.S.
• You are qualified, but experience an error in enrollment.
• You are enrolled in another Qualified Health Plan and you successfully demonstrate to the Exchange that your Qualified Health Plan has substantially violated a material provision of its contract.
• You are newly eligible or lose eligibility for advance payment of the premium tax credit, or you experience a change in eligibility for cost sharing reductions.
• You become eligible for new Qualified Health Plans offered through the Exchange because of a permanent move.
You must enroll yourself and any eligible dependents within 30 days if any of these events occur.
The idea that health insurance coverage will be mandatory was also discussed.
“The expectation that everyone will have coverage is unrealistic,” said Holdren. “There is, however, a penalty for not getting coverage, but it's not as though it's you absolutely have to.”
Page 3 of 3 - He said that the penalty would be $95, or one percent of income, for not opting to have coverage.
“The big thing is we are prepared,” Holdren stated. “We may even be overly prepared. I think in the days and weeks to come we'll maintain the ability to answer questions.”
He added that's one of the reasons there are Blue Cross stores, too. There are also plans for others to come as well.
You can view plans that Blue Cross of NEPA is offering by visiting https://store.bcnepa.com/. You can compare up to three plans at one time.
Blue Cross of NEPA also offers 12 health plans in the public marketplace.
As of Tuesday afternoon “at least 2.8 million people” visited the healthcare.gov website, according to officials overseeing the rollout of the Affordable Care Act, also known as Obamacare, the AP reported.
The website had “seven times the number” of simultaneous users ever recorded on the medicare.gov site.