NEW CASTLE (Nov. 1, 2021) – As the COVID-19 pandemic continues, Delawareans seeking health insurance, especially those who have lost coverage, can shop for 2022 coverage through the Health Insurance Marketplace. Enhanced federal subsidies, which began earlier this year under the Biden administration, will continue for 2022. The subsidies have helped to reduce consumer costs by as much as 40%.

The marketplace’s ninth open enrollment period started today, Nov. 1, and ends Saturday, Jan 15, 2022, 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 take effect Jan. 1, 2022.

Individuals who don’t act by Jan. 15, 2022, cannot get coverage for 2022 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.

Monthly premiums for 2022 plans in Delaware will be 3% higher on average than the 2021 plans, Insurance Commissioner Trinidad Navarro announced in August. Highmark Blue Cross Blue Shield Delaware is the sole health insurer offering plans on Delaware’s Health Insurance Marketplace. Enrollees will choose one of 13 Highmark plans or they will be re-enrolled automatically in a plan similar to their current one.

This year’s single-digit increase in premiums follows decreases the last two enrollment years, totaling more than 19%. Those base premium reductions and the overall stability of Delaware’s Health Insurance Marketplace reflect 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 addition, the Biden administration has made increased access to health insurance and affordability a priority by using American Rescue Plan Act funds to increase tax credits and expand subsidies further into the middle class. For instance, a family of four (both parents in their 40s) making $50,000 are eligible for a credit of roughly $16,500, compared with $14,300 previously. A majority of Delaware marketplace enrollees will be eligible for financial assistance, which can help reduce the cost of monthly premiums and/or deductibles, and lower out-of-pocket health care costs.

Through last year’s Open Enrollment and a Special Enrollment Period held earlier this year for people who lost coverage because of the pandemic, about 30,000 Delawareans now have coverage through Delaware’s Health Insurance Marketplace.

Federal tax credits are available for those whose household income is between 138% and 400% of the Federal Poverty Level. For 2022 coverage, that’s between $17,775 and $51,520 for an individual, or between $36,570 and $106,000 for a family of four. For coverage in 2021, about 81% of enrollees in Delaware were eligible for tax credits, which help reduce the cost of the monthly premium.

“All Delaware families need access to affordable, quality health care,” said Governor John Carney. “Delaware’s reinsurance program has stabilized premiums on the marketplace and the Biden administration has enhanced federal subsidies to make coverage even more affordable, even reaching into the middle class. As we continue to battle COVID-19, having access to affordable coverage is especially critical. I particularly encourage small-business owners, independent contractors and individuals who don’t have access to health insurance through an employer to check out the plans available on Delaware’s marketplace.”

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 25% of current enrollees qualify for cost-sharing reductions. For any marketplace plan in 2022, individual consumers can’t pay more than $8,700 in out-of-pocket medical costs and families can’t pay more than $17,400.

For 2022, Highmark will offer 13 plans for individuals – four gold plans, three silver, three bronze, two platinum and one catastrophic. Two dental insurers – Delta Dental of Delaware, Inc. and Dominion Dental Services, Inc. – will offer a collective 12 stand-alone dental plans on the marketplace, seven with a low actuarial level (71.6%) and five with a high actuarial level (84.2%).

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 any necessary boosters. In addition, coverage cannot be terminated due to a change in health status, including diagnosis or treatment of COVID-19.

“Providing access to high-quality, affordable health care is one of the ways that we can improve the overall health and well-being of Delawareans,” said Department of Health and Social Services Secretary Molly Magarik. “We are grateful to President Biden and our Congressional Delegation for enhancing federal subsidies to help people pay their monthly premiums. 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. Finally, with community transmission of COVID-19, we know how important having coverage is for Delawareans, especially those with chronic conditions or in other vulnerable circumstances.”

This year’s slight increase in premiums comes as the market has stabilized after a significant reduction over 19% over the past two years, said Insurance Commissioner Trinidad Navarro. “Now, more than ever, it is vital that every resident can afford the insurance they need for their families. With our work towards lower rates in recent years and the assistance of the American Rescue Plan, plans are more accessible than ever before. More than 20 percent of Delaware Marketplace participants were enrolled in a plan costing $10 or less a month in the past year.”

Assistance for Delaware enrollees

Consumers can go to HealthCare.gov or CuidadodeSalud.gov now to explore their options for 2022 coverage, and they can enroll anytime between Nov. 1 and Jan. 15, 2022.

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 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):

• Delaware’s total open enrollment for 2021 (25,320) increased about 5.6% over the previous year.
• About 81% of Delaware’s marketplace enrollees receive financial assistance to help pay their monthly premiums and/or deductibles and co-pays.
• The overall average monthly premium in Delaware is $675, with the average premium reduced to $211 per month after tax credit. For the 81% of
• Delawareans who receive financial assistance, the average premium after tax credit is $119 per month.
• Among the 25,320 people who signed up during last year’s open enrollment, about 80% were re-enrollees and 20% were new enrollees.
• Financial help is available for individuals with annual incomes up to $51,520; for a family of four the income limit is $106,000.
• About 74% of Delaware’s enrollees signed up during the final three weeks of open enrollment in 2020.

The 11-year-old Affordable Care Act (ACA), which created the Health Insurance Marketplace, allows states to waive certain ACA requirements in order to customize their health insurance systems while retaining the basic protections of the ACA. In August 2019, Governor Carney signed legislation codifying various ACA consumer protections into state law and ensuring that if the ACA is ever repealed or changed, its consumer protections will remain in effect in Delaware. This includes provisions such as guaranteed-issue coverage (regardless of medical history), coverage for essential health benefits, a ban on lifetime and annual benefit maximums, limits on out-of-pocket costs, and rules regarding the factors that insurers can use to set premiums.

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.

“No one should be without affordable, quality health insurance and starting Nov. 1, Delawareans are eligible to sign up for a plan that meets their needs and budget,” said U.S. Sen. Tom Carper. “Especially during a pandemic, I encourage everyone to visit HealthCare.Gov or seek free help from our many health insurance navigators and get covered without delay!”

“Affordable and comprehensive health insurance is critical, especially during a pandemic and nearing the height of flu season,” said U.S. Sen. Chris Coons. “Open enrollment is an opportunity for Delawareans to review and update existing health care plans or look for new coverage that best meets your needs. I’m encouraging everyone, whether you’ve got health coverage or not, to visit Delaware’s Health Insurance Marketplace to review coverage options and explore financial assistance that may be available before January 15.”

“In the midst of a pandemic, we’ve been starkly reminded of the importance of health insurance. That’s why I join with my colleagues and partners in telling Delawareans that November 1st marks the beginning of the open enrollment period for the Affordable Care Act,” said U.S. Rep. Lisa Blunt Rochester. “Experts and navigators will be on hand to help Delawareans select the plan that works best for them and their families and I encourage everyone to visit HealthCare.Gov to find out more and enroll.”

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. Note: As of Oct. 1, 2020, dental care is included in coverage for adult Medicaid enrollees in Delaware.

Both the Health Insurance Marketplace and the Medicaid expansion have helped to reduce Delaware’s uninsured rate, decreasing from 10% in 2008 to 6.6% in 2019, according to the Census Bureau. That decline includes Delawareans who could not get coverage before the Affordable Care Act because of pre-existing conditions.

National Antifraud Task Force takes on new charges to protect consumers

Delaware Insurance Commissioner Trinidad Navarro, Chair of the National Association of Insurance Commissioners’ (NAIC) Antifraud Task Force, announced today the successful creation of the Improper Marketing of Health Plans Working Group, which aims to tackle some of the nation’s most serious consumer-centered health scam efforts and end the siloed approach to addressing the issue.

“Robocalls, search engine advertisements, mailers, and endless telemarketing efforts aim to steal from those seeking comprehensive health insurance. All across the country we have seen scam artists build out networks of communication that center around selling insurance plans that do not offer residents adequate protection. They are merciless in their efforts, and they trick consumers into thinking they will have the coverage they need for their medical care” said Insurance Commissioner Trinidad Navarro. “There’s no need to sugarcoat it – there is deception occurring, and its being directed towards some of the most vulnerable residents. COVID-19 rightfully increased consumer concerns and led more people to seek out affordable insurance – but this concern has been manipulated by scammers. This Working Group will make headway towards ending these efforts to exploit residents.”

The Working Group is a new approach to address concerning increases in consumers being marketed away from ACA-compliant plans to other products that do not offer comprehensive coverage for things like preexisting conditions or hospital visits. Many improperly marketed health plans claim to be compliant, or advertise under look-a-like naming that deliberately creates confusion, such as “Bidencare,” or “Healthcare.com.”

These products may be inadvertently found by consumers searching for legitimate coverage, or on websites where a fraudulent entity has purchased advertising. Often, a consumers’ inquiry can be turned into a request for a quote without consent, and contact information is sold to third parties. The plans use of lead generators and telemarketing is so pervasive that department investigators must purchase dedicated phones for their investigations due to the intrusive, rapid-fire robocalls and text messages that can mount to more than 40 per day from a single webform completion.

The Working Group has meet informally since March 2020 to create a comprehensive conversation on the issue, combining discussions that previously took place in separate health, market conduct, and fraud committees. State and federal level regulators have attended, discussing the latest bad actors and efforts in their jurisdictions, often finding that those efforts are echoed elsewhere. Movement of scams from state to state after regulators shut them down is one of the key reasons that regulators sought approval of the subcommittee and its charges by NAIC’s Executive and Plenary Committees.

“The formation of this Working Group can help stop scams before they start,” shared Delaware Special Deputy Frank Pyle, who has served decades in law enforcement, fraud investigation, and market conduct, and lends his expertise to the new subgroup as Co-Chair. “With greater communication between regulators, those who aim to exploit consumers should be scared. Running from state to state will not be an option.”

The Working Group’s official charges include:

• Coordinate with regulators, both on a state and federal level, to provide assistance to and guidance on monitoring the improper marketing of health plans, and coordinate appropriate enforcement actions, as needed, with other NAIC Committees, task forces, and working groups.
• Review existing NAIC Models and Guidelines, including laws and regulations, that address the use of lead generators for sales of health insurance products and identify models and guidelines that need to be updated or developed to address current marketplace activities.

“The Nebraska Department of Insurance is pleased with the official recognition of this group by the NAIC. When we started this group, our goal was to create open communication between all states and the federal government in order to identify and investigate these bad actors in the improper marketing of health plans. Today, that goal is achieved, but the work is just beginning. We will utilize this group to further investigations and prosecutions of those entities and strengthen our laws so we can protect the insurance buying public from these activities,” shared Martin Swanson, Deputy Director of the Nebraska Department of Insurance and Chair of the Working Group.

Following approval of the Working Group, regulators can now formally join the committee. Ad hoc virtual meetings have consisted of contributors from nearly every state, with meetings regularly engaging 100 to 300 participants. The Working Group’s members have already taken multiple administrative actions against entities and schemes identified by the group to protect consumers. Meetings are regulator-only.

The Working Group is part of the National Antifraud Task Force, which works with insurance regulators across the country, as well as local, state, federal and international law enforcement and antifraud organizations. The Task Force provides guidance and resources for insurance departments across the country and in the U.S. Territories, including tracking and analyzing trends in fraud. Numerous subgroups inform the Task Force’s work, including the Antifraud Education Enhancement Working Group and the Antifraud Technology Working Group.

More information about non-compliant health plans

Consumers should be wary of non-marketplace plans that offer limited benefits

Insurance Commissioner Trinidad Navarro is joining commissioners across the country in cautioning residents who may be considering purchasing an insurance plan that does not adequately meet their needs or comply with Affordable Care Act (ACA) benefit requirements. The Special Enrollment Period, which started February 15, is a great time to review and enroll in insurance plans offered on the Marketplace. However, non-compliant off-marketplace plans may be heavily advertised during this period, and may appear attractive despite often being more expensive and far less comprehensive.

One health insurance alternative that is being marketed quite a lot is short-term limited benefit health insurance. This not a recommended form of coverage, and these plans do not provide coverage for pre-existing medical conditions – anything that a person has been diagnosed with or sought treatment for within the past five or more years. Limited benefit plans only cover a set number of doctor visits for a limited dollar amount and may have very high deductibles and copay requirements. These plans do not qualify for or replace a major medical, ACA-approved health insurance policy, and policies are only effective for three months and are not renewable.

Other products contain similar flaws that could put the consumer at risk of significant medical bills, including lack of coverage critical needs. Coverage for prescriptions, pre-existing conditions, surgery and outpatient procedures, hospital and emergency visits, maternity and pediatric care, and mental and behavioral healthcare could all be excluded from these plans. Non-insurance products, such as health care sharing ministries, are not regulated, and as such are not required to cover a person’s needed care. Trade association plans and other limited plans can offer low-quality coverage that does not meet ACA standards and may not meet a consumer’s needs. None of these plans offer the financial subsidies and tax credits of ACA plans, which about 86 percent of Delaware enrollees are eligible for.

Delaware consumers can ask themselves questions to better recognize problematic plans:

• Is the policy underwritten by a reputable insurer?
• Does this policy cover pre-existing medical conditions?
• Are plan details, such as coverage for maternity care, available in writing?
• Is the plan found on an official Marketplace website, like HealthCare.gov or ChooseHealthDE.com?
• Can a person enroll without any auxiliary payment, such as an enrollment fee, subscription, or membership fee?

If the answer to any of these questions is no, the plan may not be legitimate, and the consumer should reconsider the policy. Even if these red flags are not found, residents should scrutinize plan content, and, if working with an agent or broker, verify their license with the department.

While the Delaware Department of Insurance has not seen significant increases in fraudulent contact or limited benefit plan sales, the pandemic has emboldened bad actors who aim to capitalize upon unusual circumstances, including the Special Enrollment Period.

The Special Enrollment Period was authorized by President Biden and will allow Marketplace enrollment through May 15 on HealthCare.gov. Individuals who are uninsured, regardless of the reason for their lack of insurance, can enroll during this period. Existing Marketplace participants have the option to move to another plan. Local coverage navigators are available to direct consumers to appropriate plans, visit the Choose Health DE website to get connected to a local navigator, or call (800) 318-2596.

More information about the Special Enrollment Period

Second consecutive year of reductions in health insurance rates

In a year when the nation’s attention is firmly focused on healthcare and its costs, Delaware Insurance Commissioner Trinidad Navarro has announced another reduction in rates on the Delaware Health Insurance Marketplace. Despite insurer costs related to COVID-19 testing and treatment, Commissioner Navarro negotiated an average decrease of 1% in health insurance rates. Highmark Blue Cross Blue Shield Delaware, who offers the state’s Affordable Care Act health plans, initially submitted a reduction of 0.5%. The Commissioner’s final rate announcement comes after an independent actuarial review and public comments on the insurer’s proposal.

“I am proud to announce today the second consecutive rate decrease for Delaware’s Affordable Care Act plans. Amid a global pandemic, it is more important than ever for residents to have access to affordable insurance. Given the difficult economic climate, more people are relying on the Marketplace for the coverage they need,” said Commissioner Navarro. “With this decrease, we send a strong message about the effectiveness of the ACA during its 10th anniversary year. We will continue to fight to ensure access to affordable coverage for all Delawareans.”

In 2019, after successfully applying for a 1332 reinsurance waiver, the state was able to negotiate an average rate decrease of 19% for 2020 plans. This year’s modest reduction reflects market stabilization following the implementation of reinsurance.

After the rate reductions for the 2020 plan year, enrollment spiked by 6.3% during the traditional enrollment period. As of the start of the year, nearly 24,000 Delaware residents participated in marketplace-offered plans. While the federal government has not opened enrollment in response to COVID-19, residents losing employer-sponsored health coverage due to the economic impacts of the pandemic may qualify for special enrollment outside of the traditional enrollment period.

Open enrollment for the Marketplace takes place between November 1 and December 15 each year. However, residents may qualify to enroll or change plans based on special circumstances, such as a loss of qualifying health coverage, change of income, becoming a parent, and several other qualifying factors. Find out if you qualify for special enrollment.

The news of the second consecutive rate decrease comes as the department is implementing other consumer cost-of-care protection efforts, including regulating Pharmacy Benefit Managers to control and reduce medication cost, and continuing efforts to create an Office of Value-Based Healthcare Delivery to focus on primary care affordability and availability.

The proposed rate decrease does not apply to Medicare, Medicaid, or those with group or individual policies outside of the Marketplace.

More information on the rate review process

With state’s new reinsurance program in place, premiums for 2020 will be down 19%; biggest impact for those not eligible for financial help

NEW CASTLE (Oct. 31, 2019) – With the state’s new reinsurance program in place and premiums declining for the first time since Delaware’s Health Insurance Marketplace opened for enrollment in 2013, Delawareans are urged to take another look at marketplace plans during open enrollment for 2020 coverage, beginning Friday. The 19 percent drop in rates is especially significant for Delawareans who are not eligible for financial assistance on the marketplace.

The seventh open enrollment period, in which people can renew coverage or sign up for a new plan for 2020, runs from Friday, Nov. 1, through Dec. 15, at www.HealthCare.gov. Coverage for enrollees who sign up by Dec. 15 and pay their first month’s premium will be effective Jan. 1.

The state will formally mark the Health Insurance Marketplace’s seventh enrollment period with a press conference at 10 a.m. Nov. 4 at Westside Family Healthcare’s Dover Clinic, 1040 Forrest Ave. For the second straight year, Westside is the only organization in Delaware to receive federal funding for navigators to help people enroll for coverage either in person or over the phone.

“The reduction in rates for 2020 offers an important incentive to compare and shop for plans on our marketplace, especially for Delawareans who own small businesses, are independent contractors or who don’t have access to health insurance through an employer,” Governor John Carney said. “I want to thank everyone who helped create Delaware’s new reinsurance program as a critical tool to reduce rates in the individual market. It’s another way that we can connect people to quality care in our state and to better health.”

Under Delaware’s 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. The Delaware Health Care Commission will administer the program. The reinsurance program required multiple approvals at the state and federal levels. In June, Governor Carney signed enabling legislation (House Bill 193) approved by Delaware’s General Assembly that same month. In August – after public comment periods at the state and federal levels – the federal Centers for Medicare and Medicaid Services (CMS) approved Delaware’s application providing for a reinsurance program through 2024. In October, Insurance Commissioner Trinidad Navarro announced that he had approved an average rate decrease of 19 percent for the sole insurer on Delaware’s Marketplace – Blue Cross Blue Shield of Delaware. Enrollees will choose one of eight Highmark Blue Cross Blue Shield of Delaware plans that are available for purchase in 2020 or they will be automatically re-enrolled in a plan that is similar to the one they currently have.

Last year, about 22,562 people enrolled for coverage through Delaware’s Health Insurance Marketplace, including about 78 percent who re-enrolled for 2019 and 22 percent who were new enrollees.

Federal tax credits are available for those whose household income is between 138 percent and 400 percent of the Federal Poverty Level. For 2020, that’s between $17,236 and $49,960 for an individual, or between $35,536 and $103,000 for a family of four. For coverage in 2019, about 85 percent of enrollees in Delaware were eligible for tax credits, which help reduce the cost of the month premium.

“When premiums decline in the individual market – both on and off the marketplace – that often helps to reduce health insurance costs for everyone,” said Department of Health and Social Services (DHSS) Secretary Dr. Kara Odom Walker. “With premiums down 19 percent for the 2020 marketplace plans in Delaware, I urge everyone to shop for coverage on Delaware’s marketplace or to talk with their insurance agent or broker. For those who already have coverage, I encourage them to go back to HealthCare.gov or to their agent, update their information and compare plans to make sure they have the best coverage to meet their health care needs and their budget.”

“This year, our team working with the Department of Health and Social Services, utilized the Federal 1332 Waiver to see if we could further reduce health insurance rates on the ACA Market,” Commissioner Navarro said. “I’m pleased that with the waiver, we were able to reduce rates by 19 percent. The initial rate filing by Highmark Blue Cross Blue Shield of Delaware indicated a rate reduction of 5 percent. Our team at the Department carefully scrutinizes all rate requests, even the ones that reduce rates, to determine if they can be reduced further. In addition, we utilize an outside actuarial firm with no ties to insurance companies to make sure the approved rate is the lowest possible rate after taking into consideration all actuarial factors. I urge all Delawareans to log on to ChooseHealthDE.com and check the plan that best works for their situation.”

Plans on the marketplace are spread among metal-level categories – bronze, silver, gold and platinum – 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 percent of medical costs and the consumer pays about 30 percent. For any marketplace plan, the maximum annual out-of-pocket cap for 2020 is $8,200 for an individual and $16,400 for a family.

For 2020, Highmark Blue Cross Blue Shield of Delaware will offer a total of eight plans for individuals – two gold plan, two silver, three bronze and one platinum. Two insurers – Delta Dental of Delaware, Inc. and Dominion Dental Services, Inc. – will offer a collective 11 stand-alone dental plans on the marketplace, six with a low actuarial level (70 percent) and five with a high actuarial level (85 percent).

Consumers who pick silver plans might also qualify for additional savings through discounts on deductibles, copayments, and coinsurance. In Delaware, about 36 percent of current enrollees qualify for cost-sharing reductions.

All plans cover 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, and pediatric services.

Assistance for Delaware enrollees

Cosumers can go to HealthCare.gov or CuidadodeSalud.gov now to check out their options for 2020, and can enroll at any time between Nov. 1 and Dec. 15. The Centers for Medicare and Medicaid Services (CMS) announced earlier this month that the online application has been streamlined and that for the first time quality ratings will be displayed on plans on HealthCare.gov, using a five-star rating system, with five stars representing the highest quality. The rating will be based on medical care, member experience and plan administration. In some cases – when plans are new or have low enrollment – ratings may not be available. A rating of three stars or above means a health plan is considered average or above average. For 2020, 80 percent of plans eligible to receive a rating have at least three stars.

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, and by certified applications counselors at Henrietta Johnson Medical Center in Wilmington and La Red Health Center in Georgetown.

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 www.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:

• Eighty-five percent of Delaware’s current marketplace enrollees receive financial assistance to help pay their monthly premiums and/or deductibles and co-pays.
• The overall current average monthly premium in Delaware is $842, with the average premium reduced to $202 per month after tax credit. For the 85 percent of Delawareans who currently receive financial assistance, the average premium after tax credit is $110 per month.
• Among the more than 22,562 current enrollees, 78 percent were re-enrollees and 22 percent were new enrollees for 2019.
• Financial help is available for individuals with annual incomes up to $49,960; for a family of four the income limit is $103,000.
• About 75 percent of Delaware’s current enrollees signed up during the final three weeks in 2019, Nov. 25-Dec. 1, Dec. 2-8, and Dec. 9-15.
• Beginning in 2019, there is no longer a federal tax penalty for individuals who can afford coverage, but who choose not to buy it.

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.

“Lower average premiums across the country and a double-digit drop in Delaware shows that we should be focused on building on the success of the ACA – not tearing it down,” U.S. Senator Tom Carper said. “By making common sense improvements, like our state has done with the reinsurance program, we can continue to provide Delaware families with access to quality, affordable health insurance which in turn can lead to better health outcomes and reduced costs. I often say, find out what works and do more of that – and the Affordable Care Act is working. Now, we must continue to build on this progress to achieve even lower costs for families across the country and protect the Affordable Care Act that insures over 20 million Americans, including more than 20,000 Delawareans, from continued partisan attacks and attempts to scrap the law entirely. This open enrollment season, I encourage Delawareans who need health insurance to look to the marketplace and get covered.”

“Open enrollment gives Delawareans the chance to explore the different health care coverage options that are available to them each year,” said U.S. Senator Chris Coons. “Even if you have already enrolled, I encourage everyone to take this opportunity and visit the Health Insurance Marketplace at HealthCare.gov. You can update your information, compare plans, and make sure you and your family are enrolled in the plan that best fits your needs. Thanks to the Affordable Care Act, open enrollment offers folks throughout the country access to affordable, comprehensive health care coverage, regardless of how old you are, where you’re from, or whether you have a pre-existing condition.”

“Despite repeated actions from the federal government to shorten the enrollment period and cut critical outreach programs that inform consumers, I’m pleased to see such a substantial drop in premiums this year,” said Congresswoman Lisa Blunt Rochester, a member of the House Energy & Commerce Committee. “With this shortened enrollment window, it’s critical that anyone who needs coverage go to HealthCare.gov to explore what options best suit them.”

Businesses with 50 employees or fewer can offer plans to their employees starting any month of the year through the Small Business Health Options Program (SHOP). Go to HealthCare.gov or call 1 (800) 706-7893 (TTY: 711).

In addition to the Health Insurance Marketplace, some residents might be eligible for coverage though 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 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 percent in 2008 to 5.7 percent in 2018, according to a recent Census Bureau report. That decline includes Delawareans who could not get coverage before the Affordable Care Act because of pre-existing conditions. Increasing access to health care coverage is the first step toward a healthier Delaware, Secretary Walker said.

“Through our work on the health care spending and quality benchmarks for Delaware, we are adding a level of transparency to our health care system so we all can better understand where that spending is going and how those costs relate to the outcomes patients are receiving,” Secretary Walker said.