Insurance enrollment deadline a week away

Time is running out for Northwest Arkansas residents who want to get health insurance this year through the federal Affordable Care Act.

The Health Insurance Marketplace enrollment deadline is Feb. 15. The marketplace is where uninsured people who earn more than 138 percent of the federal poverty level can buy insurance. People who make up to 400 percent of the poverty level can find subsidies there.

The federal poverty level for an individual is $11,670 and $23,850 for a family of four. A person earning more than $16,104 but less than $46,680 would be eligible for a subsidy. The family of four can get a subsidy if the household earnings are between $32,913 and $95,400.

"The deadline in looming. As the deadline gets closer, people who delayed getting insurance are now seeking help," said Tyler Clark, community development manager for Community Clinic, nonprofit health care provider with nine sites across Benton and Washington counties.

The marketplace offers 72 plans from five medical insurers and 19 plans from three dental insurers.

The Arkansas Insurance Department reports statewide enrollment in the marketplace was 55,254 as of Feb. 1. The department estimates 77 percent of qualified Arkansans are still uninsured. Enrollment began in fall 2013.

Nearly one-third of enrollees call the state's northwest 12 counties home.

Statewide enrollment increased nearly 5 percent since mid-January.

Mike Rodda, district coordinator for the AARP Tax-Aide Program, said he expects some people will learn for the first time they are supposed to have insurance when they fill taxes this year.

This is the first tax season uninsured individuals face a penalty. The tax penalty is $95 per adult and $47.50 for dependents this year for those who went without insurance in 2014. The fine is capped at $285 for a family.

The penalty for people uninsured in 2015 increases to $325 per adult and $162.50 for dependents, up to $925.

Rodda is advising people who use his group's free tax preparation services about the penalty increases, but said many people say they just can't afford coverage.

AARP's Tax-Aide program started Monday, and Rodda said about eight of the 60 clients seen in the first two days were uninsured.

"A lot of times, their income is at a level that we can create an exemption for them so they don't have to pay a penalty this year," he said. "By and large people seem to be aware of it, but the people who don't have insurance just don't want to get it."

Laura Kellams, Northwest Arkansas director for Arkansas Advocates for Children and Families, said more people might sign up if they realized the low rates and tax breaks they might receive.

Nine out of 10 people who enrolled in a marketplace plan last year were eligible for a subsidy. The state's insurance department reports Arkansans with marketplace plans paid an average of $94 a month out of pocket toward premiums and received a monthly subsidy of $293.

"People have heard a lot about the law, but they don't necessarily understand how it works," Kellams said. "We hope to see a big surge of people who are trying to get enrollment information next week, but it's been tough getting the word out."

Part of the Arkansas Advocates for Children and Families' outreach effort included sending 160,000 informational mailers to people who may be eligible for the marketplace subsidy or for private option insurance. People earning less than 138 percent of the poverty level qualify for coverage under the private option, the state's expanded Medicaid program. There is no deadline to apply for private option coverage.

Arkansas Advocates also awarded more than $500,000 in grants to seven agencies across the state to pay the salaries of guides to help the uninsured sign up for insurance.

People also can get help from a broker or agent, typically someone who works for an insurance company who makes a commission on an insurance sale.

Individuals can also sign up on their own, but Kellams said the people in need of insurance are twice as likely to complete the enrollment process if they have help.

"We wanted to make sure everyone had access to unbiased people offering help," she said. "These helpers have nothing to gain from enrollment."

Seth Blomeley, Arkansas Insurance Department spokesman, said Arkansas had about 530 guides last year working through the state's contracts with 27 agencies. A legislative change last year stopped the department from funding outreach and education activities to promote marketplace enrollment, and only about 50 guides are working this year, primarily through nonprofit agencies, he said.

Another 287 people classified as certified application counselors assist people in the enrollment process at medical facilities.

Clark said the Community Clinic saw its number of guides drop to two this year. The clinic received a small grant to help defray the cost of its guides, but Clark said the nonprofit pays most of the expense.

"Our two guides are completely booked, have have been since open enrollment started again," he said. Open enrollment started Nov. 15. Anyone enrolled by the Feb. 15 deadline will have coverage March 1.

Sharif Omar, CEO of Northwest Health System, said the health system has nine certified application counselors at its three campuses. Many of the medical system's interaction with the uninsured population comes from patient interaction in physician offices and the emergency department.

Community members can also call and make an appointment or get help over the phone, he said.

"For us, our focus is to provide as much access to the community as possible," Omar said.

Christie Swanson can be reached by email at [email protected] or on Twitter @NWAChristie.

NW News on 02/08/2015