With the latest enrollment deadline under the Affordable Care Act fast approaching on Monday, Connecticut’s health insurance marketplace is offering consumers one-on-one assistance to help them navigate the process.
The controversial Affordable Care Act requires all individuals nationwide to have health insurance or face a tax penalty. Open enrollment for 2015 coverage began Nov. 15 and runs through Feb. 15, but those who want a new plan to start Jan. 1 must renew or change their plan by Monday.
Enrollment under ACA has been a bumpy road for some but officials at Access Health CT, the state’s insurance marketplace, say help is available to those who need it.
“Individuals do not have to do this by themselves,” said Jason Madrak, Access Health CT’s chief marketing officer.
Access Health CT has two storefronts, one in New Britain and one in New Haven, where people can get in-person, one-on-one assistance, he said. In addition, the marketplace has a dozen sites at partner agencies — mostly libraries, along with some nonprofit agencies and Department of Labor locations — where consumers can go for help.
Details about each site, including hours of operation, location and directions, are available at learn.accesshealthct.com/locations/.
Consumers also can find help online at accesshealthct.com or by calling (855) 909-2428.
So far, in the ongoing round of open enrollment that began Nov. 15, some 8,058 Connecticut residents have enrolled in plans offered by private insurers and 20,942 have enrolled in Medicaid plans, Madrak said. That’s more than the first year at around this time. However, the numbers last year were reversed and some 14,365 residents enrolled with one of the private insurance carriers and 9,075 had enrolled in Medicaid through the close of business Dec. 4, 2013.
Since the ACA made health insurance mandatory, consumers have had many questions. In Connecticut, most of those questions have been fielded by Access Health CT.
The marketplace was formed in the wake of ACA’s passage and has been criticized in recent months by some who say consumers aren’t informed enough about how to navigate the complicated enrollment process.
To that end, Access Health CT has budgeted nearly $1 million for outreach efforts. The marketplace has trained hundreds of individuals to help guide consumers through the process and operates storefronts where people can get one-on-one help enrolling.
Problems and confusion haven’t been unique to Connecticut; many consumers nationwide had issues signing up for 2014 health care coverage. The initial rollout was hindered by widespread problems with the federal government’s healthcare.gov website.
Access Health was created specifically to meet the requirements of the ACA, under which states had to establish their own health care marketplace or allow the federal government to operate an exchange on their residents’ behalf.
Consumers who opt to go without insurance will be fined if they are caught, and the penalties for not having insurance will be higher next year than they were this year.
The fee in 2015 will be 2 percent of the individual’s income or $325 per adult and $162.50 per child, whichever is greater. Only the amount of income above the tax filing threshold — roughly $10,000 for an individual — is used to calculate the penalty, according to the government’s website.
Last year the penalty was 1 percent of income or $95 per adult and $47.50 per child under age 18.
Penalties are to be paid when individuals file their tax returns, according to the government. There are exemptions for those uninsured for less than three months of the year, those for whom the cheapest coverage would cost more than 8 percent of their household income, those who don’t have to file a tax return because their income is too low, and several other circumstances.
After Monday, the next major deadline for consumers will be Feb. 15. Those who have not enrolled in 2015 coverage by then generally can’t buy marketplace health insurance for 2015 unless they qualify for a special enrollment period. Special enrollment periods are 60-day spans following certain life events, like marriage, the birth of a child, or the loss of other coverage.