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


Highmark, Aetna Request Substantial Health Insurance Rate Increases for 2017

Highmark, Aetna Request Substantial Health Insurance Rate Increases for 2017

Commissioner Stewart Announces Public Information Sessions

Dover, DE – Commissioner Karen Weldin Stewart announced today that she has received rate request filings from Highmark Blue Cross Blue Shield of Delaware, Aetna, Inc. and Aetna Life for individual and small group plans to be offered on Delaware’s Health Insurance Marketplace in 2017. Highmark is asking for a 32.5% increase in the individual market, while Aetna, Inc. requests 25.0% and Aetna Life 23.9%. In the small group market, Highmark seeks a 2.7% increase, Aetna, Inc. asks for 23.2%, and Aetna Life requests 18.6%.

“These large rate increase requests are occurring in many states across the country, and I know they will be a burden for many Delawareans,” said Stewart. “The proposed increases are substantial and I’m going to do my best to reduce them. As is the case with every rate request I receive, I am instructing my actuaries to aggressively examine Highmark’s and Aetna’s supporting data for their requests.”

“I remind consumers that these are proposed rates, not final rates,” added Commissioner Stewart, who also announced that the Insurance Department will conduct public information sessions to receive comment on the proposed increases. The sessions will take place at the following locations in the three counties:

Monday, June 20th at 6:00 p.m. Carvel State Office Building
Auditorium/Mezzanine Level
820 N. French Street
Wilmington, DE 19801

Tuesday, June 21st at 11:00 a.m. Delaware Tech Owens Campus
College Theater, Arts & Science Center
21179 College Drive
Georgetown, DE 19947

Tuesday, June 21st at 6:30 p.m. Delaware Department of Insurance
Sussex Conference Room, First Floor
841 Silver Lake Boulevard Dover, DE 19904

Representatives from Highmark and Aetna will be present at each session. Consumers and interested parties may also submit written comments to the Department at ratedivision@delaware.gov until July 15, 2016. Comments may also be submitted in writing to:

Delaware Department of Insurance

Attn: Health Insurance Rate Comments

841 Silver Lake Blvd.

Dover, DE 19904

According to Title 18 of the Delaware Code, insurance companies may not charge rates that are “excessive, inadequate or unfairly discriminatory.” The staff at DOI reviews rate filings and independent actuaries retained by DOI review the supporting data to see if the rate changes are justified by the circumstances as presented by the insurance companies. The rate requests and the insurers’ justifications will be posted at www.delawareinsurance.gov during the comment period. The Commissioner reviews the actuaries’ findings and the public comment and works with the insurers to arrive at a rate. That rate is submitted to the Centers for Medicare & Medicaid Services (CMS) for subsequent review. CMS must follow its own regulations and Delaware law before finally approving or denying the requests.

 

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View the Health Insurance Rate Filings webpage: http://www.delawareinsurance.gov/departments/rates/ratefilings.shtml

www.delawareinsruance.gov | Main Office: 302-674-7300


Insurance Commissioner Karen Weldin Stewart Releases 2016 Health Insurance Rates for Delaware Marketplace Plans

(DOVER, DE) – Insurance Commissioner Karen Weldin Stewart today released Delaware’s Qualified Health Plan rates for Plan Year 2016.  The Commissioner, after review, submitted her approved rates to the Centers for Medicare & Medicaid Services (CMS) in August. CMS has final authority on the rates. CMS concurred with the Commissioner’s recommendations and announced their approval on September 21, 2015.

 

It is the Commissioner’s duty to evaluate the reasonableness of rates to ensure rates are not excessive, inadequate or unfairly discriminatory.

 

The Commissioner recommended approval of a 22.4% rate increase in the individual market for Highmark Blue Cross Blue Shield of Delaware, a reduction of 3.0% from Highmark’s June request of 25.4%.  Highmark had made a second request in late August for an additional 8% increase, for an overall rate hike of more than 33% which the Commissioner rejected out of hand.

 

Aetna Life Insurance Company’s request for a 16% increase in the individual market was also approved. In the small group market, Highmark’s request for a 12.7% increase was granted, as was Aetna’s request for a 6.1% decrease.

 

“My actuaries took a hard look at Highmark’s submitted rate request, and we were able to reduce it by 3.0%,” said Commissioner Stewart. “But Blue Cross franchisees across the country are making requests for increases of 25% or more, claiming the Affordable Care Act has unleashed pent-up demand by persons who have not seen a doctor for years.  Regulators have been approving significant rate increases throughout the country.”

 

BCBS plans have requested rate hikes greater than 30% in Oklahoma, Tennessee and Minnesota.  Last month Blue Cross Blue Shield New Mexico pulled out of that state’s healthcare exchange when denied a 51.6% increase.

 

Commissioner Stewart said, “I’m continuing to meet with other insurance companies to persuade them to join Delaware’s Health Insurance Marketplace and increase competition. Insurers have been discouraged by our state’s high health care costs.” According to a 2013 Wall Street Journal report[1] on health care spending nationwide, Delaware ranks third-highest in prescription drug costs, fourth in the cost of physician and clinical services, and ninth in the cost of hospital care.

 

The Department of Insurance held public information sessions in each county in June to receive comment on the proposed rate increases. Written comments can be found at the department’s website. The department expects to post all of the rates on their website by October 15, 2015. For details visit the Health Insurance Rate Filings page, http://www.delawareinsurance.gov/departments/rates/ratefilings.shtml

 

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[1] JOURNAL REPORTS: HEALTH CARE Health-Care Costs: A State-by-State Comparison

By LOUISE RADNOFSKY, Updated April 8, 2013 4:00 p.m. ET, http://www.wsj.com/articles/SB10001424127887323884304578328173966380066

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For Immediate Release

For more information: Frank Pyle @ 302-674-7353

 www.delawareinsurance.gov | Main Office: 302-674-7300


Highmark, Aetna Request Significant Health Insurance Rate Increases

Highmark, Aetna Request Significant Health Insurance Rate Increases
Commissioner Karen Weldin Stewart Vows Vigorous Review

(DOVER, DE) Commissioner Karen Weldin Stewart announced today that she has received rate request filings from Highmark Blue Cross Blue Shield of Delaware and Aetna, Inc. for individual and small group plans to be offered on Delaware’s Health Insurance Marketplace in 2016.  Highmark is asking for a 25.4% increase in the individual market, while Aetna requests a 16% increase. In the small group market, Highmark seeks a 12.7% increase, while Aetna asks for a 6.1% decrease.

 

“Large rate increase requests like these are occurring in several states across the country and I know they will cause a hardship for many Delawareans,” said Stewart. “The increases are substantial and I’m going to do my best to reduce them. I am instructing my actuaries to examine vigorously Highmark’s and Aetna’s supporting data for the requests.”

 

Commissioner Stewart also announced that the Insurance Department will conduct public information sessions in June to receive comment on the proposed rate increases.  The sessions will take place at the following locations in the three counties:

 

Monday, June 15   1:00pm    Del Tech Owens Campus, Georgetown

Monday, June 15   6:00pm    Insurance Department, 841 Silver Lake Blvd., Dover

Tuesday, June 16   6:00pm    Carvel State Office Building, 820 N. French St. Wilmington

 

Representatives from Highmark and Aetna will be present at each session. Consumers and interested parties may also submit written comments to the Department at ratedivision@delaware.gov for 30 days between June 15 and July 15, 2015.

 

According to Title 18 of the Delaware Code, insurance companies may not charge rates that are “excessive, inadequate or unfairly discriminatory.” The staff at DOI reviews rate filings and independent actuaries retained by DOI review the supporting data to see if the rate changes are justified by the circumstances as presented by the insurance companies. The rate requests and the insurers’ justifications will be posted at www.delawareinsurance.gov during the 30-day comment period. The Commissioner reviews the actuaries’ findings and the public comment and works with the insurers to arrive at a rate.  That rate is submitted to the Centers for Medicare & Medicaid Services (CMS) for subsequent review. CMS must follow its own regulations and Delaware law before finally approving or denying the requests.

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For immediate release
Contact Jerry Grant 302-674-7303


The Health Insurance Marketplace Open Enrollment Period Has Passed, But You May Qualify for a Special Enrollment Period

Important Deadline Approaching April 30; Beware of Scams

Dover, DE The open enrollment period for the Health Insurance Marketplace, www.healthcare.gov, ended on February 15; however, some people may qualify for a special enrollment period (SEP) going on right now. If you owe a fee with your taxes for not having qualifying health coverage in 2014, and you don’t yet have health insurance for 2015, you may still be able to get coverage for this year. Time to apply is limited; this special enrollment period ends on April 30.

“If you don’t have health insurance in 2015 you’ll risk having to pay the fee again next year,” said Insurance Commissioner Karen Weldin Stewart. The fee for people who don’t have coverage increases in 2015 to $325 per person or 2% of your household income – whichever is higher. Eighty percent of people who apply for financial assistance received some level of support to help pay for monthly premiums.

If you owe the fee for not having qualifying coverage in 2014, you may still be eligible to enroll in 2015 coverage if all of these apply:

  • You didn’t know until after open enrollment ended on February 15, 2015 that the health care law required you and your household to have health coverage, or you didn’t understand how the requirement would impact you and your household;
  • You owe the fee for not having coverage in 2014; and
  • You aren’t already enrolled in 2015 coverage through the Health Insurance Marketplace or outside the Marketplace.

Healthcare.gov states that, “You don’t need to have filed your 2014 taxes before enrolling with this SEP—you just have to owe the fee.” The website further states, “If any person in a household meets the criteria for this SEP, everyone in the household can enroll with it.” Please note: Even if you get 2015 coverage through the SEP, you still owe the fee for 2014.

Other special enrollment periods are available throughout the year if you experience certain life changes, such as having a baby, getting married, or losing your existing health coverage. To see if you qualify, please visit www.choosehealthde.com or www.healthcare.gov.

Small businesses can apply for Small Business Health Options Program (SHOP) coverage for their employees any time, all year long.

Fraud, scams and harassment: If you try to obtain a health insurance policy outside of the open enrollment period which complies with the Affordable Care Act, you will probably find very few options. Nevertheless, within the past week the Department of Insurance’s Consumer Services division has received several complaints about harassing phone calls from callers trying to sell limited benefit plans to consumers, sometimes insinuating that the callers’ plans qualify as full health insurance coverage. It most likely does not comply.

There have also been recent reports of scammers calling and impersonating IRS agents, telling people that they need to pay fines or enroll in a plan immediately. Remember, the IRS does not generally conduct business via telephone and you should never give out personal information to anyone if you are suspicious of the call or feel pressured to “act immediately”. Never provide your social security number or credit card number to anyone who demands it.

If you are contacted by an agent who is selling a legitimate insurance product, he or she is required by law to provide you with the name of the insurance company that the agent is representing, and the agent’s ID number. If you request that information, and the alleged agent will not provide it, then the call is almost certainly a scam. Before you purchase any benefit plan or insurance policy, you are encouraged to call the Delaware DOI Consumer Services division at 1-800-282-8611 to verify that the agent is licensed to sell insurance policies in Delaware. For more information about health insurance topics please visit www.delawareinsurance.gov.

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Contact:  Jerry Grant

(302) 674-7303