Increased competition means more options for Delawareans, employers

For the second consecutive year, Delawareans will have access to increased options on the Health Insurance Marketplace, Insurance Commissioner Trinidad Navarro announced today, with 57 total plans offered by four insurers. In the 2024 plan year, consumers will have the opportunity to purchase plans from Celtic Insurance Company Ambetter Health of Delaware, a carrier new to the state’s marketplace, in addition to plans from Aetna Health, AmeriHealth Caritas, and Highmark Blue Cross Blue Shield of Delaware. As recently as the 2022 plan year, consumers had only one carrier and 12 plan options to choose from.

“Improving healthcare accessibility and affordability across our state is one of my top priorities, and I’m proud that our work has led both options and enrollments to an all-time high,” said Insurance Commissioner Trinidad Navarro. “In addition, our Office of Value-Based Health Care Delivery has confirmed carrier’s filings reflect compliance with our affordability standards, including increasing spending on primary care to lower overall cost of care. We look forward continuing to make progress in this work.”

Nearly 35,000 residents purchased plans on the Delaware Marketplace during last year’s open enrollment. After Advance Premium Tax Credits, premiums averaged $197. Nearly 6,000 residents were eligible for a premium of $10 a month or less. Enrollment numbers are expected to rise as Medicaid redeterminations continue following the end of the COVID-19 Public Health Emergency. A Special Enrollment Period for Marketplace plans is available for persons no longer eligible for Medicaid.

As always, Commissioner Navarro urges residents to be informed consumers and shop for the best plan for both their needs and their budget. 57 health plans and 12 dental plans are available to Delawareans for the 2024 plan year, and local navigators are available to assist in choosing the right plan. Open Enrollment takes place November 1 through January 15.

Be aware of non-compliant alternative health plans.

Individual Affordable Care Act (ACA) Marketplace Rates Announced

Following in-depth reviews by independent actuaries and the Office of Value-Based Health Care Delivery, rates for regulated 2024 health, dental, and small group insurance plans were also announced today.

Celtic Ins. Co. Ambetter Health of Delaware’s 24 new plans range in base cost, before premium tax credits or other subsidies, from $378 to $532. Aetna Health (as a PA Corp.) will increase rates by an average of 2%, with base rate for six plans ranging from $414 to $441. AmeriHealth Caritas will decrease rates an average of 4.52%. Base rates for their six Marketplace plans will cost $300 to $416. Highmark requested a rate increase, and an average increase of 3.2% was approved after an initial increase request of 4.9%. Their 18 Marketplace plans have base costs between $274 and $654.

Plans on the marketplace are spread among metal-level categories – bronze, silver, gold, platinum and catastrophic – and are based on how enrollees choose to split the costs of care with their insurance company.

Other ACA and ACA-Compliant Rates
Off-market individual offerings include six plans from Aetna Health (as a PA Corp.), which will increase an average of 2% in cost for the future year. AmeriHealth Caritas will decrease its plan’s rates an average of 4.52%. Highmark’s two off-market plan costs will increase an average of 3.2% after an initial request of 4.9%.

Delta Dental will increase rates by an average of 4.2% for two offered marketplace plans, and one off-market plan. Dominion Dental will decrease ACA premiums by 0.1% on their 10 plans.

Off-market small group plan options will increase for the coming plan year, with rate finalization occurring in October. Rate submissions show 62 plan options offered by six carriers: Aetna Health, Aetna Health (as a PA Corp), Aetna Life, Highmark, Optimum Choice, and United Healthcare.

About ACA Plans
All ACA-compliant health plans offer essential health benefits, including coverage of pre-existing conditions, prescriptions, emergency services and hospitalization, mental and behavioral health coverage, outpatient care, telehealth, lab services, and more.

Open enrollment for 2024 Health Insurance Marketplace plans begins November 1. Residents may qualify to enroll or change plans based on special circumstances throughout the year, such as income qualification, loss of health coverage, becoming a parent, or other qualifying factors.

Find out if you qualify for special enrollment.

NEW CASTLE (Jan. 27, 2023) – With more choice in plans than ever before, enhanced federal subsidies, and Delaware’s reinsurance program keeping the cost of monthly premiums relatively steady, enrollment on Delaware’s Health Insurance Marketplace for 2023 again set an all-time high, increasing 8% over the open enrollment total for 2022.

During Delaware’s 10th open enrollment period, which began on Nov. 1, 2022, and ended Jan. 15, 2023, a total of 34,742 Delawareans enrolled for health insurance on HealthCare.gov. During the previous year, sign-ups during the open enrollment period totaled 32,113. For those who enrolled by Dec. 15, 2022, and paid their first premium, coverage began Jan. 1, 2023. For those who enrolled by Jan. 15, 2023, and paid their first premium, coverage will begin Feb. 1, 2023.

“All Delaware families need access to affordable, quality health care,” said Governor John Carney. “This year, we celebrated the 10th year of open enrollment on Delaware’s Health Insurance Marketplace with more plans to choose from, helping to make coverage even more affordable. With record-breaking enrollment numbers, we know Delawareans are prioritizing their health. Thank you to all the community navigators and health advocates who helped us reach this milestone.”

“Marketplace plans play a crucial role in improving access to high-quality and affordable health care,” said Department of Health and Social Services Secretary Molly Magarik. “I am thrilled to see a record number of Delawareans taking advantage of the many affordable options offered through Delaware’s Health Insurance Marketplace, and we are grateful to the community navigators and application counselors who worked hard during open enrollment to help individuals and families find the plan that was right for them.”

This year, Delawareans were able to choose from three insurers, compared to only one last year, and a total of 30 plans, the highest total in the 10 years of the marketplace. Insurance Commissioner Trinidad Navarro announced in June 2022 that two new insurers – AmeriHealth Caritas (four plans) and Aetna CVS Health (nine plans) – would join Highmark Blue Cross Blue Shield Delaware (17 plan options) in offering coverage on the marketplace for 2023.

All plans offer essential health benefits such as coverage of pre-existing conditions, outpatient care, emergency services, hospitalization, prescription drugs, mental health and substance use disorder services, lab services, pediatric services, birth control and breastfeeding coverage, and COVID-19 vaccines, including the updated bivalent booster. In addition, coverage cannot be terminated due to a change in health status, including diagnosis or treatment of COVID-19.

“Judging from the final enrollment numbers, it is clear that Delaware consumers appreciate being able to choose from a variety of plans at prices that are affordable,” said Insurance Commissioner Trinidad Navarro. “Affordable, high quality health care is critical to Delaware consumers, and market stability and increased competition are key to helping provide consumer-friendly health insurance options in Delaware.”

The overall stability of Delaware’s Health Insurance Marketplace reflects continued federal approval of Delaware’s reinsurance program. The program has lowered health insurance premiums for plans sold in the individual insurance market by partially reimbursing insurers for high-cost health care claims through a fund that uses a mix of federal funding and assessments collected by the Delaware Department of Insurance from health insurance carriers. Because the insurers’ claims costs are lower, the insurers can reduce the cost of premiums or limit increases.

In 2021, the Biden administration made expanding access to health insurance and affordability a priority through the American Rescue Plan Act, which increased tax credits and expanded subsidies into the middle class. This year, the passage of the Inflation Reduction Act continued those enhanced benefits through 2025. For instance, a family of four (both parents in their 40s) making $50,000 are eligible for a credit of roughly $16,000, compared with $14,300 previously.

“Over a decade ago, when crafting the Affordable Care Act, we had one goal in mind: to make affordable, quality health care available to all Americans – and the marketplaces were vital to reaching that goal,” said U.S. Senator Tom Carper. “Now, we are seeing enrollment numbers go up year after year, and more Delawareans are able to get preventative screenings at no cost and get access to health care services previously not afforded to them. I thank the hard-working navigators for their work enrolling uninsured Delawareans in plans that work best for their families, and I look forward to continuing our work to drive down health care costs for all Americans.”

“Over the past decade, the Affordable Care Act has made affordable, quality health care coverage a reality for millions of Americans,” said U.S. Senator Chris Coons. “I’m proud to have worked with President Biden and my colleagues to strengthen the ACA in the American Rescue Plan and Inflation Reduction Act, further driving down costs for families, and am excited to see record numbers of Delawareans benefitting from this landmark legislation this year.”

“Ensuring that Delawareans have accessible, affordable, high-quality health care is critical to the health and well-being of communities across the First State,” said U.S. Rep. Lisa Blunt Rochester. “I am encouraged to see that this year a record number of Delawareans signed up for health care coverage through Delaware’s marketplace. This would not have been possible without the hard work of DHSS, Insurance Commissioner Navarro, and Community Navigators such as Westside Family Healthcare and Quality Insights that were on the ground guiding Delawareans and providing the resources they needed to find plans that fit them and their families best. I am grateful to be a partner in keeping Delaware healthy and remain as committed as ever in advocating for more affordable, accessible, high-quality health care for Delawareans in the 118th Congress.”

Delawareans who need help enrolling in coverage have access to free in-person assistance from federally funded and trained specialists at Westside Family Healthcare (statewide) and Quality

Insights, Inc., (New Castle and Sussex counties) and by certified application counselors at Henrietta Johnson Medical Center in Wilmington and La Red Health Center in Georgetown. Westside and Quality Insights each received increased federal funding for navigators to help people enroll for coverage.

“As a Federally Qualified Health Center, Westside understands how health insurance coverage reduces barriers to routine care and can save lives” said Lolita Lopez, President & CEO of Westside Family Healthcare. “Westside has provided enrollment assistance in the Health Insurance Marketplace since 2013, and we are thrilled with the record-breaking results during this open enrollment period. We commend the work of our state partners to reduce premium costs making coverage on the Delaware Health Insurance Marketplace more affordable than ever before.”

“We are very pleased to see a continued increase in those taking advantage of the affordable coverage offered through the Marketplace,” said Shanen Wright, Program Director of Quality Insights’ Navigator program. “And although 2023 open enrollment has concluded, we are available year-around to help Delaware residents learn more about their coverage options for 2024, or to enroll this year for those who become newly eligible through a qualifying event. We encourage anyone in need of information or assistance to reach out at qualityinsights.org/navigator or 1-844-238-1189.”

With the end of open enrollment on the health insurance marketplace, Delawareans can enroll for coverage 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. Visit HealthCare.gov/screener to see if you qualify.

In addition to the health insurance marketplace, some Delawareans might be eligible for coverage through Delaware’s Medicaid program, which is open year-round. To be screened for eligibility or to apply for Medicaid benefits, go to Delaware ASSIST.

Los residentes de Delaware encontrarán más opciones en aseguradoras y planes, y subsidios federales incrementados continuos para ayudar con la asequibilidad; la registración se extiende hasta el 15 de Enero del 2023

NEW CASTLE (1º de Noviembre, 2022) – Saliendo de un año con sin precedentes por la inscripción en el Mercado de Seguros Médicos de Delaware, los residentes de Delaware buscando cobertura para el 2023 encontrarán más opciones de aseguradoras y planes que antes visto, y seguirán encontrando subsidios federales mejorados, lo cual empezó el año anterior bajo la administración de Biden. Los subsidios han ayudado a reducir el costo del consumidor de hasta un 40%.

El décimo periodo de inscripción abierta comenzó hoy, 1º de Noviembre y termina el 15 de Enero del 2023 en www.CuidadoDeSalud.gov, donde los consumidores pueden renovar cobertura existente o inscribirse en un nuevo plan. La cobertura para miembros que se inscriban antes del 15 de Diciembre y paguen la prima del primer mes entrará en vigencia el 1º de Enero.

Los individuos que no actúen antes del 15 de Enero de 2023 no podrán obtener cobertura para 2023 al menos que califiquen para un Período de Inscripción Especial basado en circunstancias como la pérdida de cobertura médica calificada, cambio de ingresos, volverse un padre u otros factores calificantes.

Este año, los residentes de Delaware tendrán de tres aseguradoras para elegir versus solo una el año pasado y un total de 30 planes, el total más alto en los 10 años del mercado. El Comisionado de Seguros, Trinidad Navarro, anunció en Junio que dos nuevas aseguradoras, AmeriHealth Caritas (cuatro planes) y Aetna CVS Health (nueve planes), se unirían a Highmark Blue Cross Blue Shield Delaware (17 opciones de planes) para ofrecer cobertura en el mercado para 2023. En septiembre, el Comisionado Navarro anunció que las tarifas de Highmark aumentarían un 5.5% en promedio.

La estabilidad general del Mercado de Seguros Médicos de Delaware refleja la aprobación federal continua del programa de reaseguros de Delaware. El programa ha reducido las primas de seguro médico para los planes vendidos en el mercado de seguros individuales al reembolsar parcialmente a las aseguradoras los reclamos de atención médica de alto costo a través de un fondo que utiliza una combinación de fondos federales y evaluaciones recaudadas por el Departamento de Seguros de Delaware de los portadores de seguros médicos. Debido a que los costos de reclamos de las aseguradoras son más bajos, las aseguradoras pueden reducir el costo de las primas o limitar los aumentos.

Durante la inscripción abierta del año pasado, un total de 32,113 residentes de Delaware se inscribieron para la cobertura de 2022 en el Mercado de Seguros Médicos de Delaware, un aumento del 26.8% del año anterior.

“Todas las familias de Delaware necesitan acceso a atención médica de calidad asequible,” dijo el Gobernador John Carney. “Hay más planes para elegir este año, lo que ayudará a que la cobertura sea aún más asequible. Animo a todos los residentes de Delaware a mirar sus opciones, especialmente a los propietarios de pequeñas empresas, contratistas independientes y personas que no tienen acceso a un seguro médico a través de un empleador. Es importante que prioricemos nuestra salud.”

En 2021, la administración de Biden hizo que la expansión al acceso a seguro médico y la asequibilidad una prioridad a través de la Ley del Plan de Rescate Estadounidense, que aumentó los créditos fiscales y expandió los subsidios hacia la clase media. Este año, la aprobación de la Ley para la Reducción de la Inflación continuó con esos beneficios incrementados hasta 2025. Por ejemplo, una familia de cuatro (ambos padres de 40 años) que ganan $50,000 son elegibles para un crédito de aproximadamente $16,000, en comparación con los $14,300 anteriores.

Adicionalmente, el gobierno federal cambió a principios de este mes la forma en que se determina la asequibilidad de la cobertura del empleador para los miembros de la familia de un empleado, el llamado “fallo familiar.” A partir del 2023, los familiares de una persona a la que se les ofrece cobertura basada en el empleador que es “asequible” solo para el empleado y no para toda la familia, pueden ser elegibles para créditos fiscales por primera vez en el mercado. Este cambio ayudará a más consumidores a calificar para créditos fiscales y reducciones de costos compartidos a través de un plan de mercado.

Los créditos fiscales federales están disponibles para aquellos cuyos ingresos familiares se encuentran entre el 138% y el 400% del nivel federal de pobreza. Para la cobertura de 2023, eso es entre $18,754 y $54,360 para una persona, o entre $38,295 y $111,000 para una familia de cuatro. Para la cobertura en el 2022, alrededor del 89% de los afiliados en Delaware eran elegibles para créditos fiscales, lo que ayuda a reducir el costo de la prima mensual.

Los planes en el mercado se distribuyen entre categorías de nivel de metales (bronce, plata, oro, platino y catastrófico – y se basan en cómo los afiliados eligen dividir los costos de cuidado con su compañía de seguros. Los planes bronce tienen primas mensuales bajas pero altos costos cuando necesita atención; los planes dorados tienen primas altas, pero costos más bajos cuando necesita atención. En un plan plata, la aseguradora paga alrededor del 70% de los costos médicos y el consumidor paga alrededor del 30%. Los consumidores que eligen planes de atención médica plata también pueden calificar para ahorros adicionales a través de descuentos en deducibles, copagos y coaseguros. En Delaware, alrededor del 23% de los afiliados actuales califican para reducciones de costos compartidos. Para cualquier plan del mercado en 2023, los consumidores individuales no pueden pagar más de $9,100 en gastos médicos de bolsillo y las familias no pueden pagar más de $18,200.

Para 2023:

• Highmark ofrecerá 17 planes para individuos: tres planes de platino, seis de oro, tres de plata, cuatro de bronce y uno catastrófico.
• Aetna CVS Health ofrecerá nueve planes: dos de oro, cuatro de plata y tres de bronce.
• AmeriHealth Caritas ofrecerá cuatro planes: uno dorado, uno plateado y dos bronce.
• Dos aseguradoras dentales, Delta Dental of Delaware, Inc. y Dominion Dental Services, Inc. – ofrecerán un total de 13 planes dentales independientes en el mercado, siete con un nivel actuarial bajo (paga menos mensualmente, pero más cuando obtienes servicios dentales) y seis con un nivel actuarial alto (paga más mensualmente, pero menos cuando recibes atención dental).

Todos los planes ofrecen beneficios esenciales de salud, como cobertura de condiciones preexistentes, atención ambulatoria, servicios de emergencia, hospitalización, recetas medicas, servicios de salud mental y trastornos por uso de sustancias, servicios de laboratorio, servicios pediátricos, control de la natalidad y cobertura de lactancia, y vacunas de COVID-19, incluido el nuevo refuerzo bivalente. Además, la cobertura no puede cancelarse debido a un cambio en el estado de salud, incluyendo el diagnóstico o tratamiento de COVID-19.

“A medida que ingresamos al décimo año de inscripción abierta del Mercado de Seguros Médicos de Delaware, estamos agradecidos por el importante papel que desempeñan los planes del mercado para mejorar el acceso a una atención médica asequible y de alta calidad,” dijo la Secretaria del Departamento de Salud y Servicios Sociales Molly Magarik. “Y apreciamos la estabilidad que la administración Biden, nuestra delegación del congreso, el Comisionado de Seguros y que nuestro propio programa de reaseguro han aportado al mercado. Urgimos a todos a que vuelvan a mirar la asequibilidad de los planes en el Mercado de Seguros Médicos de Delaware y vean cómo la cobertura puede encajar en el presupuesto de su familia.”

“El Mercado de Seguros Médicos de Delaware es más exitoso que nunca con tasas constantes, subsidios mejorados y la inscripción en su punto más alto,” dijo el Comisionado de Seguros Trinidad Navarro. “Estoy muy orgulloso de que, de cara al 2023, los consumidores también se beneficiarán de la mayor competencia que ha visto nuestro estado, con tres aseguradoras y 30 opciones de planes para elegir”.

Asistencia para afiliados Delaware

Los consumidores pueden ir a HealthCare.gov o a CuidadodeSalud.gov ahora para explorar sus opciones para la cobertura del 2023, y se pueden inscribir en cualquier momentos desde el 1º de Noviembre hasta el 15 de Enero, 2023.

Los residentes de Delaware que necesiten ayuda inscribiéndose en cobertura tendrán acceso a asistencia en persona gratuita financiados con fondos federales por especialistas capacitados Westside Family Healthcare (en todo el estado) y Quality Insights, Inc., (condados de New Castle y Sussex) y por asesores de solicitud certificados en Henrietta Johnson Medical Center en Wilmington y La Red Health Center en Georgetown. Westside y Quality Insights recibieron cada uno más fondos federales para navegadores para ayudar a las personas a inscribirse en la cobertura.
Agentes e intermediarios de seguros con licencia estatal también están disponibles para ayudar a individuos para volver a inscribirse y ayudar a los empleadores a actualizar su cobertura, sin cargo adicional.

Para más información, visite www.ChooseHealthDE.com. Puede inscribirse en la cobertura del mercado en CuidadodeSalud.gov o llamando al 1-800-318-2596 (TTY: 1-855-889-4325).

De acuerdo con el Departamento de Salud y Servicios Humanos de EE. UU. (HHS):

• Alrededor del 89% de los inscritos en el mercado de Delaware recibieron asistencia financiera en 2022 para ayudarlos a pagar sus primas mensuales y/o deducibles y copagos.
• La prima mensual promedio general en Delaware es de $706, con una prima promedio reducida a $169 por mes después del crédito fiscal. Para el 89% de los residentes de Delaware que recibieron asistencia financiera, la prima promedio después del crédito fiscal es de $114 por mes.
• Entre las 32,113 personas que se inscribieron durante la inscripción abierta del año pasado, alrededor del 78% eran reinscritos y el 22% eran nuevos inscritos.
• Ayuda financiera está disponible para individuos con ingresos anuales de hasta $54,360; para una familia de cuatro, el límite de ingresos es de $111,000.
• Aproximadamente el 62% de los miembros de Delaware se inscribieron durante las tres semanas anteriores al 15 de diciembre de 2021.

Apoyo de la Delegación del Congreso

Los senadores y representantes de EEUU de Delaware urgieron a los residentes de Delaware que no tienen seguro a averiguar qué hay disponible para ellos en el mercado.

“Estoy orgulloso que pudimos extender los subsidios de la Ley del Cuidado de Salud a Bajo Precio (ACA) y hacer que el seguro médico sea más asequible para los Estadounidenses hasta 2025 con la aprobación de la Ley para la Reducción de la Inflación,” dijo el Senador Americano Tom Carper. “Ahora en su décimo año, el mercado es más asequible que nunca y los residentes de Delaware tienen más opciones que antes. ¡Animo a todos a visitar CuidadodeSalud.gov o buscar ayuda gratuita con nuestros muchos navegadores de seguros de salud y obtener cobertura sin demora!”

“A medida que avanzamos al décimo año de inscripción abierta, está claro que la Ley del Cuidado de Salud a Bajo Precio ha permitido a los residentes de Delaware a acceder a un seguro de salud asequible y de calidad a través del mercado de seguros,” dijo el Senador Americano Chris Coons. “Solo en este año, mis colegas y yo pudimos extender subsidios críticos para este programa a través de la Ley para la Reducción de la Inflación para garantizar que más familias puedan pagar el seguro médico que necesitan sin tener que tirar la casa por la ventana. A partir de hoy, los residentes de Delaware tienen más opciones que nunca para protegerse a sí mismos y a sus familias, y deben visitar CuidadodeSalud.gov para inscribirse o cambiar su seguro antes del 15 de enero.”

“A raíz de la pandemia de COVID-19, el acceso a un seguro de salud asequible y de calidad nunca ha sido más importante. Es por eso por lo que voté para aprobar la Ley para la Reducción de la Inflación en agosto, que extiende los subsidios de la ACA, lo que reduce el costo de la atención médica para los residentes de Delaware inscritos en la cobertura de atención médica a través del Mercado de Seguros Médicos de Delaware,” dijo la Representante Americana Lisa Blunt Rochester. “Y este año, los residentes de Delaware tienen más opciones que nunca para encontrar un plan asequible que funcione mejor para ellos y sus familias. Me complace unirme a mis colegas—el Senador Carper y el Senador Coons—así como al Comisionado de Seguros Navarro para anunciar que hoy, 1º de Noviembre, marca el comienzo del período de inscripción abierta para que los residentes de Delaware se inscriban en la cobertura de atención médica a través del mercado. Los residentes de Delaware tienen hasta el 15 de Enero de 2023 para revisar sus planes actuales, inscribirse en un nuevo plan u obtener más información en HealthCare.gov. ¡No pierda la oportunidad de obtener cobertura!”

Además del Mercado de Seguros Médicos, algunos residentes pueden ser elegibles para la cobertura a través del programa ampliado de Medicaid de Delaware, que está abierto todo el año. Más de 10,000 residentes de Delaware reciben cobertura bajo la expansión de Medicaid cada año. Para ser evaluado o solicitar los beneficios de Medicaid, vaya a Delaware ASSIST.

Tanto el Mercado de Seguros Médicos como la expansión de Medicaid han ayudado a reducir la tasa de personas sin seguro de Delaware, decreciente del 10% en 2008 al 5.7% en 2021, según la Oficina del Censo. Esa disminución incluye a los residentes de Delaware que no pudieron obtener cobertura antes de la Ley del Cuidado de Salud a Bajo Precio debido a condiciones preexistentes.

Delawareans will find more choice in insurers and plans, and continuing enhanced federal subsidies to help with affordability; enrollment runs through Jan. 15, 2023

NEW CASTLE (Nov. 1, 2022) – Coming off a record-breaking year for enrollment on Delaware’s Health Insurance Marketplace, Delawareans seeking coverage for 2023 will find more choice in insurers and plans than ever before, and continue to find enhanced federal subsidies, which began last year under the Biden administration. The subsidies have helped to reduce consumer costs by as much as 40%.

The marketplace’s 10th open enrollment period started today, Nov. 1, and ends Jan. 15, 2023, at www.HealthCare.gov, where consumers can renew existing coverage or sign up for a new plan. Coverage for enrollees who sign up by Dec. 15 and pay their first month’s premium will be effective Jan. 1.

Individuals who don’t act by Jan. 15, 2023, cannot get coverage for 2023 unless they qualify for a Special Enrollment Period based on circumstances such as a loss of qualifying health coverage, change of income, becoming a parent, or other qualifying factors.

This year, Delawareans will have three insurers to choose from vs. only one last year, and a total of 30 plans, the highest total in the 10 years of the marketplace. Insurance Commissioner Trinidad Navarro announced in June that two new insurers – AmeriHealth Caritas (four plans) and Aetna CVS Health (nine plans) – would join Highmark Blue Cross Blue Shield Delaware (17 plan options) in offering coverage on the marketplace for 2023.

In September, Commissioner Navarro announced that Highmark’s rates would increase 5.5% on average. The overall stability of Delaware’s Health Insurance Marketplace reflects continued federal approval of Delaware’s reinsurance program. The program has lowered health insurance premiums for plans sold in the individual insurance market by partially reimbursing insurers for high-cost health care claims through a fund that uses a mix of federal funding and assessments collected by the Delaware Department of Insurance from health insurance carriers. Because the insurers’ claims costs are lower, the insurers can reduce the cost of premiums or limit increases.

During last year’s open enrollment, a total of 32,113 Delawareans enrolled for 2022 coverage on Delaware’s Health Insurance Marketplace, an increase of 26.8% over the previous year.

“All Delaware families need access to affordable, quality health care,” said Governor John Carney. “There are more plans to choose from this year, which will help to make coverage even more affordable. I encourage all Delawareans to look through your options, especially small-business owners, independent contractors and individuals who don’t have access to health insurance through an employer. It’s important we prioritize our health.”

In 2021, the Biden administration made expanding access to health insurance and affordability a priority through the American Rescue Plan Act, which increased tax credits and expanded subsidies into the middle class. This year, the passage of the Inflation Reduction Act continued those enhanced benefits through 2025. For instance, a family of four (both parents in their 40s) making $50,000 are eligible for a credit of roughly $16,000, compared with $14,300 previously.

In addition, the federal government earlier this month changed the way that the affordability of employer coverage is determined for members of an employee’s family, the so-called “family glitch.” Starting in 2023, family members of a person who is offered employer-based coverage that is “affordable” for the employee only and not the whole family, may be eligible for tax credits on the marketplace for the first time. This change will help more consumers qualify for tax credits and cost-sharing reductions through a marketplace plan.

Federal tax credits are available for those whose household income is between 138% and 400% of the Federal Poverty Level. For 2023 coverage, that’s between $18,754 and $54,360 for an individual, or between $38,295 and $111,000 for a family of four. For coverage in 2022, about 89% of enrollees in Delaware were eligible for tax credits, which help reduce the cost of the monthly premium.

Plans on the marketplace are spread among metal-level categories – bronze, silver, gold, platinum and catastrophic – and are based on how enrollees choose to split the costs of care with their insurance company. Bronze plans have low monthly premiums but high costs when you need care; gold plans have high premiums but lower costs when you need care. In a silver plan, the insurer pays about 70% of medical costs and the consumer pays about 30%. Consumers who pick silver health care plans might also qualify for additional savings through discounts on deductibles, copayments, and coinsurance. In Delaware, about 23% of current enrollees qualified for cost-sharing reductions. For any marketplace plan in 2023, individual consumers can’t pay more than $9,100 in out-of-pocket medical costs and families can’t pay more than $18,200.

For 2023:

• Highmark will offer 17 plans for individuals – three platinum plans, six gold, three silver, four bronze and one catastrophic.
• Aetna CVS Health will offer nine plans – two gold, four silver and three bronze.
• AmeriHealth Caritas will offer four plans – one gold, one silver and two bronze.
• Two dental insurers – Delta Dental of Delaware, Inc. and Dominion Dental Services, Inc. – will offer a collective 13 stand-alone dental plans on the marketplace, seven with a low actuarial level (pay less monthly, but more when you get dental services) and six with a high actuarial level (pay more monthly, but less when you get dental care).

All plans offer essential health benefits such as coverage of pre-existing conditions, outpatient care, emergency services, hospitalization, prescription drugs, mental health and substance use disorder services, lab services, pediatric services, birth control and breastfeeding coverage, and COVID-19 vaccines, including the new bivalent booster. In addition, coverage cannot be terminated due to a change in health status, including diagnosis or treatment of COVID-19.

“As we enter the 10th year of open enrollment on Delaware’s Health Insurance Marketplace, we are grateful for the important role that marketplace plans are playing in improving access to high-quality and affordable health care,” said Department of Health and Social Services Secretary Molly Magarik. “And we appreciate the stability that the Biden administration, our congressional delegation, the Insurance Commissioner and our own reinsurance program have all brought to the marketplace. I urge everyone to take another look at the affordability of the plans on Delaware’s Health Insurance Marketplace and look at how the coverage can fit into your family’s budget.”

“Delaware’s Health Insurance Marketplace is more successful than ever before with steady rates, enhanced subsidies, and enrollment at an all-time high,” said Insurance Commissioner Trinidad Navarro. “I am so proud that going into 2023, consumers will also benefit from the most competition our state has seen, with three insurers and 30 plan options to choose from.”

Assistance for Delaware enrollees

Consumers can go to HealthCare.gov or CuidadodeSalud.gov now to explore their options for 2023 coverage, and they can enroll anytime between Nov. 1 and Jan. 15, 2023.

Delawareans who need help enrolling in coverage will have access to free in-person assistance from federally funded and trained specialists at Westside Family Healthcare (statewide) and Quality Insights, Inc., (New Castle and Sussex counties) and by certified application counselors at Henrietta Johnson Medical Center in Wilmington and La Red Health Center in Georgetown. Westside and Quality Insights each received increased federal funding for navigators to help people enroll for coverage.

State-licensed insurance agents and brokers are also available to help individuals re-enroll and to help employers update their coverage, at no extra charge.

For more information, go to www.ChooseHealthDE.com. You can enroll in marketplace coverage at HealthCare.gov or by calling 1-800-318-2596 (TTY: 1-855-889-4325).

According to the U.S. Department of Health and Human Services (HHS):

• About 89% of Delaware’s marketplace enrollees received financial assistance in 2022 to help pay their monthly premiums and/or deductibles and co-pays.
• The overall average monthly premium in Delaware is $706, with the average premium reduced to $169 per month after tax credit. For the 89% of Delawareans who received financial assistance, the average premium after tax credit is $114 per month.
• Among the 32,113 people who signed up during last year’s open enrollment, about 78% were re-enrollees and 22% were new enrollees.
• Financial help is available for individuals with annual incomes up to $54,360; for a family of four the income limit is $111,000.
• About 62% of Delaware’s enrollees signed up during the three weeks before Dec. 15, 2021.

Support from Congressional Delegation

Delaware’s U.S. senators and representative urged uninsured Delawareans to find out what’s available for them on the marketplace.

“I am proud that we were able to extend Affordable Care Act (ACA) subsidies and make health insurance more affordable for Americans through 2025 with the passage of the Inflation Reduction Act,” said U.S. Sen. Tom Carper. “Now in its 10th year, the marketplace is more affordable than ever, and Delawareans have more options than before. I encourage everyone to visit HealthCare.gov or seek free help from our many health insurance navigators and get covered without delay!”

“As we go into the 10th year of open enrollment, it’s clear that the Affordable Care Act has enabled Delawareans to access quality, affordable health insurance through the insurance marketplace,” said U.S. Sen. Chris Coons. “Just this year, my colleagues and I were able to extend critical subsidies for this program through the Inflation Reduction Act to ensure that more families can pay for the health insurance they need without breaking the bank. Starting today, Delawareans have more options than ever before to protect themselves and their families, and they should visit HealthCare.gov to sign up for or change their insurance before January 15.”

“In the wake of the COVID-19 pandemic, access to quality, affordable health insurance has never been more important. That’s why I voted to pass the Inflation Reduction Act in August which extends ACA subsidies, reducing the cost of health care for Delawareans enrolled in health care coverage through Delaware’s Health Insurance Marketplace,” said U.S. Rep. Lisa Blunt Rochester. “And this year, Delawareans have more options than ever before to find an affordable plan that works best for them and their families. I’m glad to join my colleagues – Senator Carper and Senator Coons – as well as Insurance Commissioner Navarro to announce that today, November 1st, marks the beginning of the open enrollment period for Delawareans to sign up for health care coverage through the marketplace. Delawareans have until January 15, 2023, to review their current plans, enroll in a new plan, or get more information at HealthCare.gov. Don’t miss the chance to get covered!”

In addition to the Health Insurance Marketplace, some residents might be eligible for coverage through Delaware’s expanded Medicaid program, which is open year-round. More than 10,000 Delawareans receive coverage under the Medicaid expansion each year. To be screened for or to apply for Medicaid benefits, go to Delaware ASSIST.

Both the Health Insurance Marketplace and the Medicaid expansion have helped to reduce Delaware’s uninsured rate, decreasing from 10% in 2008 to 5.7% in 2021, according to the Census Bureau. That decline includes Delawareans who could not get coverage before the Affordable Care Act because of pre-existing conditions.