Enrollment on Delaware’s Health Insurance Marketplace up More Than 6% for Coverage in 2020

NEW CASTLE (Dec. 23, 2019) – With a new reinsurance program driving down the cost of monthly premiums, enrollment on Delaware’s Health Insurance Marketplace increased more than 6% during the open enrollment period that ended earlier this month.

Open enrollment began on Nov. 1 and ended Dec. 17, after the U.S. Department of Health and Human Services extended the sign-up period by two days because of technical glitches on Dec. 15, the final scheduled day to buy coverage. Through Dec. 17, a total of 23,981 Delawareans had signed up for 2020 coverage through the marketplace, an increase of 6.3% from a similar period last year, when a total of 22,562 people enrolled. Nationally, enrollment declined slightly to 8.3 million, or a drop of about 2.4% from 2018.

For those who enrolled by Dec. 17 and paid their first premium, coverage will begin Jan. 1, 2020.

“We are pleased that an increased number of Delawareans decided to buy coverage through Delaware’s Affordable Care Act health insurance marketplace,” Governor John Carney said. “Since the ACA was implemented, we have nearly cut the uninsured population in half in our state. That is another important step in moving us to a stronger and healthier Delaware.”

Under Delaware’s new reinsurance program, a portion of high-cost health care claims that drive up insurance rates for everyone will be reimbursed through a $27 million fund, using a mix of federal funding and assessments collected by the Delaware Department of Insurance from health insurance carriers. With the reinsurance program in place, the sole insurer on Delaware’s marketplace reduced premiums for 2020 on average by 19%. It was the first time that premiums declined since the marketplace opened for enrollment in 2013.

“I am grateful to Governor Carney, the General Assembly, the Congressional Delegation, the Department of Insurance and many other community partners in supporting the reinsurance program for our state, which drove down the cost of premiums on Delaware’s marketplace,” said Department of Health and Social Services (DHSS) Secretary Dr. Kara Odom Walker, a practicing family physician. “As a physician, I know that having coverage makes a big difference for people because they have that critical connection to quality health care.”

For 2020, Highmark Blue Cross Blue Shield of Delaware is the only insurer on Delaware’s marketplace, offering a total of eight plans for individuals and families – two gold plans, two silver, three bronze and one platinum. The metal categories are based on how enrollees choose to split the costs of care with their insurance company. Two insurers – Delta Dental of Delaware, Inc., and Dominion Dental Services, Inc. – offer a total of 11 stand-alone dental plans, six with a low actuarial level (70 percent) and five with a high actuarial level (85 percent).

With the end of open enrollment, Delawareans can enroll in coverage only if they experience a life event that qualifies them for a special enrollment period. Among the many qualifying life events are birth or adoption of a child, a permanent move, loss of other coverage through a job, and marriage or divorce. In addition to the health insurance marketplace, some Delawareans might be eligible for coverage through Delaware’s expanded Medicaid program, which is open year-round. More than 10,000 Delawareans have received coverage under the Medicaid expansion. To be screened for eligibility or to apply for Medicaid benefits, go to Delaware ASSIST.


ACA Marketplace Rates to Decrease 19% in Delaware for Plan Year 2020

Dover, DE – Insurance Commissioner Trinidad Navarro officially announced the final approval of the 2019 Affordable Care Act (“ACA”) rates. Highmark Blue Cross Blue Shield of Delaware (“Highmark BCBSD”), the only insurer currently on the Marketplace, originally proposed a rate decrease of 5.8% for its 2019 individual Marketplace business. Commissioner Navarro, ultimately approved a decrease of 19%, after the implementation of a state-run reinsurance program, the first decrease ever since the Marketplace opened in 2013.

The approved decrease was a result of federal approval for the State of Delaware to implement a state-run reinsurance program as established pursuant to the 1332 State Innovation Waiver Application (“Waiver”). Under this program, individual market policies that meet certain minimum criteria, as set forth in the Waiver, will be eligible for reimbursement from a state-administered fund. The fund will be financed through a 1% assessment on the individual, small and large group market premium amounts for all health insurance carriers operating in those markets in Delaware. The assessment will take place annually and may vary depending on the federal government’s actions on the Health Insurance Industry Fee.

“I am happy to announce the first rate decrease in Delaware since the beginning of the Health Insurance Marketplace. In spite of the many efforts in Washington to dismantle the Affordable Care Act, we have been able to work with our state counterparts and stakeholders to give Delaware policyholders much-needed premium relief. I thank Secretary Walker for the work she and her team at DHSS put into seeing the Waiver across the finish line.”

Because this year’s filing may result in lower costs for many consumers, the Department urges consumers to examine their rates and reapply for coverage through the Marketplace.

Presently, approximately 23,000 Delawareans have health insurance through the Affordable Care Act and may be affected by these rates.

Please be advised that the proposed rate decrease will not apply to Delawareans on Medicare, Medicaid, or those with group or individual policies outside of the Marketplace.

 

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Contact: Vince Ryan

Office: (302) 674-7303

Email: vince.ryan@delaware.gov

                                                          

Delaware Department of Insurance

http://www.insurance.delaware.gov

Dover Office: 302-674-7300

Consumer Services Division: 1-800-282-8611


Health Insurance Marketplace Open Enrollment Period Ends January 31; See Plan Options and Enroll at Healthcare.gov

Dover, DE-The open enrollment period for the Health Insurance Marketplace ends on January 31, 2017. If you qualify for coverage through the Marketplace, tomorrow is the last day you will be able to sign up for a health insurance plan for 2017. In previous years there has been a surge in website traffic and phone calls to sign up in the final days of the open enrollment period, sometimes causing the federal government to issue extensions. No extensions are expected to be issued this year so consumers need to sign up now if they want to be covered. “Eight out of ten uninsured Delawareans who were eligible for a Marketplace plan qualified for some level of financial assistance to help offset the cost of monthly premiums,” said Insurance Commissioner Trinidad Navarro.

Ready to enroll? Consumers can find more details about the various plans and their related premiums and deductibles, as well as any potential premium subsidies they may be eligible for www.healthcare.gov. Federal application counselors are also available to help with enrollment 24 hours a day, 7 days a week, by calling 1-800-318-2596. All of the plans sold on the federal marketplace meet the coverage standards and consumer protections mandated by the Affordable Care Act (ACA).

“It is important for consumers to be cautious when shopping for health insurance coverage outside of the Marketplace, especially when looking for plans online,” said Commissioner Navarro. The Department of Insurance’s Consumer Services Division has received numerous complaints from members of the public who thought they had enrolled in an ACA-compliant plan only to learn that they had actually purchased a limited benefit plan. A limited benefit medical plan is not a comprehensive major medical plan, nor is it intended to replace a major medical plan.

After January 31, 2017, you cannot buy a health insurance plan for the rest of 2017 unless you have a qualifying life event—a change in your situation like having a baby, getting married, or losing other health coverage — which makes you eligible for a Special Enrollment Period. Once you have enrolled in a plan, check your mail for information from your insurance company. When a welcome packet has arrived or is delivered to your email inbox, be sure to read the information thoroughly and save everything in a secure place.

It is also very important that you pay your premium on time. If you fail to pay your monthly premiums then your insurance company can eventually cancel your policy. If your policy is cancelled due to non-payment you will likely not qualify for any other coverage until January 1, 2018.

“When you are shopping for health insurance coverage it is important to consider more than just the cost of the monthly premium alone,” said Commissioner Navarro. “Before you enroll in a plan make sure you know how much the deductible will be since deductibles on different plans can vary by thousands of dollars. It is also important to see what the plan will require you to contribute for co-pays or co-insurance,” he said. Need help understanding the words and terms used by the health insurance industry? Visit https://www.healthcare.gov/glossary/ for simple definitions.

Small businesses can apply for SHOP coverage for their employees any time, all year. Simply click on the Small Business tab at the top of Healthcare.gov to get started.

For more information about health insurance visit www.choosehealthde.com or www.healthcare.gov.

Additional resources are available at insurance.delaware.gov. Consumers in Delaware who have insurance related issues or complaints may also contact the Delaware Department of Insurance Consumer Services Division at 1-800-282-8611.

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Contact: Vince Ryan

Office: (302) 674-7303

Mobile: (302) 387-7670

Vince.Ryan@delaware.gov

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Delaware Department of Insurance

http://www.insurance.delaware.gov

Dover Office: 302-674-7300

Consumer Services Division: 1-800-282-8611


Insurer Fined $487,000 for Selling Bogus ACA Health Insurance Policies

Commissioner Stewart: Beware of Non-compliant Plans

DOVER, DE  – Insurance Commissioner Karen Weldin Stewart today announced she has fined Companion Life Insurance Company $487,000.00 for numerous violations of Delaware’s insurance code, including misrepresenting its limited benefit and short term health insurance plans as compliant with the Affordable Care Act.

The fine results from a market conduct examination of Companion conducted earlier this year by Delaware Insurance Department examiners following numerous complaints from Delaware consumers. Companion, a South Carolina company, entered into a Stipulation and Consent Order agreement with the Department on November 2, in which the company admitted to multiple code violations, including failure to provide consumers with pertinent information relating to plan coverage and failure to conduct periodic audits of the operations of two third-party administrators employed by Companion.

The examination revealed that 242 Delaware consumers had purchased non-compliant plans from Companion. One hundred forty-five policyholders chose to terminate their plans, and Companion refunded premiums totaling $18,008.99. Some consumers chose to keep the policies as a stop-gap measure.

“Consumers have to be careful when choosing a health insurance plan online,” said Commissioner Stewart. “The different plans can be confusing and some do not comply with ACA requirements. Before you purchase a policy, please visit www.choosehealthde.com to connect with ACA-approved health navigators who can provide you with free help in picking a plan that’s right for you.”

A copy of the Stipulation and Consent Order and the Market Conduct Exam Report for the Companion matter may be found at http://delawareinsurance.gov/departments/documents/enforcement/actions.shtml.

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Commissioner Stewart: Beware of Unscrupulous Tax Preparers

Por favor, encuentre la traducción al español de esta nota de prensa debajo de la versión en inglés.

Dover, DE  – Commissioner Karen Weldin Stewart has received reports of tax preparers who are wrongly informing Delawareans without health insurance that they are subject to penalty payments under the Affordable Care Act (ACA). Some unscrupulous preparers actually tell clients that the payments can be paid directly to that preparer, who then pockets the money.

These reports follow a January 26 Internal Revenue Service alert warning that preparers are targeting consumers with limited English skills, primarily Spanish speakers. Undocumented immigrants, who may seek legal status in the future and are careful not to run afoul of the law, are particularly vulnerable to such a scam. According to the IRS, immigrants who are not lawfully present in the United States are actually exempt from the requirement to have health insurance, because they are not U.S. citizens.

In fact, most consumers are not subject to the ACA tax penalty, because they have already purchased coverage, are covered through their employer or Medicaid, or qualify for an exemption. A complete list of exemptions can be found at https: https://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/ACA-Individual-Shared-Responsibility-Provision-Exemptions.

Commissioner Stewart advises: “The IRS maintains a list of credentialed tax preparers at http://irs.treasury.gov/rpo/rpo.jsf. If you believe you do owe an ACA penalty payment, follow the advice of the IRS: the payment should be made only with your tax return or in response to a letter from the IRS. The payment should never be made directly to an individual or return preparer.”

The complete text of the IRS alert is below. Please note: the IRS refers to the ACA penalty payment as an individual shared responsibility payment.

 

Affordable Care Act Consumer Alert: Choose Your Tax Preparer Wisely
IRS Health Care Tax Tip 2016-10, January 26, 2016

The IRS urges you to choose your tax professional carefully in response to reports from last year describing unscrupulous preparers. In some cases, these preparers were instructing their clients to make individual shared responsibility payments directly to that preparer. In some cases, this was happening even though the taxpayer had Medicaid or other health coverage. Under this circumstance, the taxpayer didn’t need to make the shared responsibility payment at all. In some parts of the country, unscrupulous return preparers were targeting taxpayers with limited English proficiency and, in particular, those who primarily speak Spanish.

Most people don’t owe the payment at all because they have health coverage or qualify for a coverage exemption. However, if you owe a payment, remember that it should be made only with your tax return or in response to a letter from the IRS. The payment should never be made directly to an individual or return preparer.

Preparers who inappropriately ask for direct payment use a variety of invalid reasons that include:
• telling individuals that they must make an individual shared responsibility payment directly to the preparer   because of their immigration status
• promising to lower the payment amount if the client pays it directly to the preparer
• demanding money from individuals who are exempt from the individual shared responsibility payment

If you are not a U.S. citizen or national, and are not lawfully present in the United States, you are exempt from the individual shared responsibility provision and do not need to make a payment. For this purpose, an immigrant with Deferred Action for Childhood Arrivals (DACA) status is considered not lawfully present and therefore is exempt. You may qualify for this exemption even if you have a social security number.

If you believe you have been targeted by an unscrupulous preparer or you have been financially affected by a tax return preparer’s misconduct or improper tax preparation practices, you can report it to the IRS on Form 14157, Complaint: Tax Return Preparer.

You can use our Interactive Tax Assistant tool – Am I required to make an Individual Shared Responsibility Payment? to help determine if you qualify for an exemption or owe the payment.

Choose a Tax Preparer Carefully

The vast majority of tax professionals provide honest, high-quality service. However, the IRS encourages taxpayers to avoid dishonest and unscrupulous preparers by choosing their preparer wisely. To help, the IRS offers a new, online, searchable public directory of tax preparers who currently hold professional credentials recognized by the IRS or certain other qualifications.

For information on choosing a preparer, filing a complaint about an unscrupulous preparer, or using the new directory, see our “Choosing a Tax Professional” page on IRS.gov.

Find out more about the tax-related provisions of the health care law at IRS.gov/aca.

Using tax preparation software is the easiest way to file a complete and accurate tax return. Visit the E-File Options page on IRS.gov for information.

Subscribe to IRS Tax Tips to get easy-to-read tips from the IRS by e-mail.

IRS Health Care Tax Tip 2016-10, January 26, 2016

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Comisionada Stewart: Cuidado con los Preparadores de Impuestos Inescrupulosos

Dover, DE (Marzo 10, 2016)- La Comisionada Karen Weldin Stewart ha recibido reportes de preparadores de Impuestos que están mal informando a personas de Delaware sin seguro médico que corren peligro de multas bajo la Ley del Cuidado de Salud (Affordable Care Act). Algunos preparadores de impuestos mal intencionados  les informan a sus clientes que las multas se las pueden pagar directamente a ellos, y después se quedan con el dinero ellos mismos.

Estos reportes se han dado después de la alerta brindada por la Administración Federal de Ingresos Públicos (IRS por sus siglas en inglés) en Enero 26, advirtiendo que algunos preparadores están dirigiéndose a los consumidores que hablan poco inglés; sobre todo, aquellos que hablan español. Los inmigrantes indocumentados, que buscan legalizarse en un futuro y están siendo cuidadosos de no faltar a ley, son más vulnerables a este tipo de estafa. Según el IRS, los inmigrantes quien no residen legalmente en los Estados Unidos están en realidad exentos del requisito de tener un seguro médico, porque no son ciudadanos de los Estados Unidos.

De hecho, la mayoría de consumidores no están sujetos a pagar la multa bajo la Ley del Cuidado de Salud, porque ya han comprado cobertura, están cubiertos bajo su empleador o por Medicaid, o califican para una exención. Una lista completa puede ser encontrada en la siguiente página web: https://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/ACA-Individual-Shared-Responsibility-Provision-Exemptions

La Comisionada Stewart aconseja: “El IRS mantiene una lista de preparadores de impuestos acreditados en esta página web: http://irs.treasury.gov/rpo/rpo.jsf. Si usted cree que debe una multa bajo la Ley del Cuidado de Salud, siga el consejo del IRS: el pago debe ser hecho solamente con su declaración de impuestos o en respuesta a una carta de parte del IRS. El pago nunca debe ser echo directamente a una persona o a un preparador de impuestos.

El texto completo de la alerta del IRS puede ser encontrado abajo. Por favor tome nota: el IRS se refiere a la multa bajo la Ley del Cuidado de Salud como una responsabilidad de pago compartida individualmente.

Alerta de la Ley del Cuidado de SaludEscoja a su Preparador de Impuestos Sabiamente

IRS Health Care Tax Tip 2016-10, January 26, 2016 

El IRS urge a que usted escoja su preparador de impuestos cuidadosamente en respuesta a los informes del año pasado que describen preparadores de impuestos mal intencionados. En algunos casos, estos preparadores mal intencionados instruían a sus clientes que hagan pagos individuales de responsabilidad compartida directamente a ellos.

En unos casos, esto estaba pasando aunque la persona pagando impuestos tuviera Medicaid u otro tipo de seguro médico. Bajo estas circunstancias el pagador de impuestos no tenía por qué pagar ninguna multa. En unas partes del país, los preparadores de impuestos estaban enfocándose principalmente en los consumidores que hablan poco inglés, predominantemente los que hablan español.

La mayoría de las personas no deben ninguna multa porque tienen seguro médico o califican para una exención de cobertura. Pero si debe un pago, recuerde que debe ser hecho solamente con su declaración de impuestos o en respuesta a una carta de parte del IRS. El pago nunca debe ser hecho directamente a una persona o a un preparador de impuestos.

Los preparadores que inapropiadamente solicitan un pago directo utilizan una variedad de razones inválidas. Estas son algunas:

  • Le dicen a las personas que el pago de la multa bajo la Ley del Cuidado de Salud debe ser hecho directamente al preparador de impuestos debido a su estatus legal.
  • Prometen que se reducirá el monto del pago si lo hacen directamente al preparador de impuestos
  • Exigen dinero de personas que están exentas del pago individual de responsabilidad compartida.

Si usted no es un ciudadano de Estados Unidos ni nacionalizado, y no reside legalmente en los Estados Unidos, usted está exento de la multa bajo la Ley del Cuidado de Salud y no necesita hacer ningún pago. En este caso, un inmigrante con Acción Diferida para los Llegados en la Infancia (DACA) está considerado como una persona que no reside de manera legal en los Estado Unidos, por lo cual también está exento a pagar la multa. Es posible que usted califique para la exención aun cuando tenga un número de seguro social.

Si usted cree que ha sido víctima de un  preparador de impuestos mal intencionado o ha sido afectado económicamente por la conducta inapropiada de un preparador de impuestos, puede reportarlo al IRS usando esta forma: Form 14157, Complaint: Tax Return Preparer.

(https://www.irs.gov/pub/irs-pdf/f14157.pdf)

Puede usar nuestra herramienta interactiva de Asistente de Impuestos- ¿Estoy obligado a pagar la multa bajo la Ley Del Cuidado de La Salud para ayudar a determinar si usted califica para una exención o debe pagar la multa.

Escoja al Preparador de Impuestos Cuidadosamente 

La mayoría de los profesionales de impuestos proporcionan un servicio honesto y de alta calidad. Sin embargo, el IRS aconseja a pagadores de impuestos que eviten a los preparadores de impuestos mal intencionados y sin escrúpulos, escogiendo cuidadosamente a su preparador. El IRS ofrece un nuevo directorio público de preparadores de impuestos quienes actualmente tienen credenciales profesionales reconocidas por el IRS o ciertas otras cualificaciones.

Para obtener información sobre cómo elegir un preparador, cómo presentar una queja sobre un preparador sin escrúpulos, o cómo utilizar el nuevo directorio, vea nuestra página sobre la “Elección de un Profesional de Impuestos ” en IRS.gov

Encuentre más información sobre temas relacionados con los impuestos y la Ley del Cuidado de Salud en IRS.gov/aca

Usar un software de preparación de impuestos es la forma más fácil de presentar una declaración de impuestos completa y exacta. Visita la página de opciones de E -File en IRS.gov para obtener información.

Suscríbase a Consejos sobre Impuestos del IRS para obtener consejos y fáciles de leer de parte del IRS por correo electrónico.

IRS Health Care Tax Tip 2016-10, January 26, 2016

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