BY CHERYL SLAVIN
A significant event has quietly taken place October 1. On this date every state must have in place an online health insurance marketplace as mandated by the federal Affordable Care Act (ACA). These marketplaces are designed to provide health insurance consumers the means to easily shop and compare the various health plans offered by participating providers, thus increasing the availability of affordable health care to a greater percentage of the public.
In light of this latest development, State Assemblywoman Ellen Jaffee hosted an information session at the Suffern Library last Thursday as a way to educate the community about the ACA and the New York State of Health Marketplace, New York State’s answer to the mandate.
Alice Yaker, Director of Outreach for the New York State Department of Health, gave a lengthy presentation about the benefits and functions of the Marketplace. Every health insurance provider participating in the Marketplace—New York has 16— is required by federal law to offer 10 essential health benefits to consumers, including preventive and wellness care, pediatric care, hospitalization and prescription drugs. Moreover, no one can be turned down due to a pre-existing condition.
The state anticipates a 53 percent overall drop in the cost of premiums because more people will be entering the pool of insured consumers. Costs will also drop as a result of increased competition and government regulation. Participating insurers must now justify any premium increase over 10% before the rate takes effect. Additionally, individuals with incomes between 100 and 400 percent of the poverty rate will be eligible for additional government subsidies or tax credits. This means that a family of four with an income under $94,200 can pay significantly less for health insurance than it would before the enactment of the ACA.
To access the Marketplace and start comparing the different plans offered, consumers must enroll online at nystateofhealth.ny.gov. Participants must be ready to give certain essential information including social security numbers, proof of income and essential facts about current health insurance in order to browse the site. This information will help to determine an applicant’s insurance budget, as well as whether the applicant is eligible for any financial assistance. Once a participant finds a plan that works for the individual or the family, he or she can enroll in that plan through the Marketplace. The New York State of Health Marketplace will also provide options for small business owners looking to offer health insurance to their employees.
For those who need or would prefer assistance, there is a Customer Service Call Center available at 855-355-5777. Trained staff can walk a person through the entire online process or can help the person enroll over the phone. Additionally, certified enrollment experts or navigators, provided by community organizations and trained by the State Department of Health, will be available at various locations to offer in person guidance throughout the process. The Rockland County Department of Health can provide a list of the times and locations where personal assistance is available. Traditional insurance brokers can also be trained and certified in the use of the Marketplace.
Nancy Haggerty, Program Director from the Rockland County Department of Health and Andrew Lehto, Special Populations Manager from HRHCare also spoke at the meeting. Haggerty explained that the County Department of Health was one of the agencies providing county-wide navigators in many languages including French, Spanish and Creole. The County will refer small business owners to trained brokers for assistance. Inquiries to the County can be emailed to [email protected].
HRHCare is also a designated community organization providing navigators and can be reached at its website, hrhcare.org or by email at [email protected]. Lehto cautioned the public to carefully examine all costs of any plan, including co-pays and deductibles as well as premiums, when deciding what plan works within a consumer’s budget.
The open enrollment period for insurance through the Marketplace will be from October 1, 2013 through March 31, 2014, affording plenty of time for interested parties to get all their questions answered. Thereafter, open enrollment will take place once a year from October 1 through December 7. Insurance benefits will take effect on January 1, 2014. For more information, visit nystateofhealth.ny.gov, call the customer service number, or email at [email protected]. Assemblywoman Jaffee’s office can be reached at 845-624-4601, or at [email protected].