NEW CASTLE (Dec. 13, 2018) – Delawareans have just days left to sign up for or to change their health coverage for 2019 through the Health Insurance Marketplace. Open enrollment ends on Dec. 15, with coverage for those who enroll by that date and who pay their first premium beginning Jan. 1, 2019.

State residents can sign up for coverage at www.HealthCare.gov or by calling 1-800-318-2596 (TTY: 1-855-889-4325). Free, in-person assistance is available through Westside Family Healthcare at 302-472-8655 in New Castle County and 302-678-2205 in Kent and Sussex counties. State-licensed insurance agents and brokers also can help individuals enroll or re-enroll and help employers update their coverage, at no extra charge. For contact information, go to www.ChooseHealthDE.com.

As of Dec. 8, 10,378 Delawareans had signed up for 2019 coverage through the Health Insurance Marketplace, a decrease of 10 percent from a similar period last year. For 2018, 24,500 people enrolled for coverage, including more than half who signed up for or renewed their coverage in the final week of open enrollment.

“We urge Delawareans who need coverage through the Health Insurance Marketplace to take action now to enroll. The deadline will not be extended,” said Department of Health and Social Services (DHSS) Secretary Dr. Kara Odom Walker, a board-certified family physician. “As a physician, I see the difference that having access to insurance, as well as the connection to care that coverage brings.”

Consumers can go to HealthCare.gov to shop for coverage for 2019, compare plans and to enroll before midnight Saturday, Dec. 15. Individuals who need help enrolling can receive free in-person assistance from federally funded and trained specialists at several Delaware organizations, including Westside Family Healthcare, Henrietta Johnson Medical Center in Wilmington and La Red Health Center in Georgetown.

Westside Family Healthcare is hosting drop-in enrollment sessions through Saturday. The schedule:

Bear/New Castle Health Center, 404 Fox Hunt Drive, Bear (near the Bear Post Office)

• Thursday, Dec. 13: 4-7 p.m.
• Friday, Dec. 14: 4-7 p.m.
• Saturday, Dec. 15: 9 a.m.-noon

Fourth Street Wilmington Health Center, 1802 W. Fourth St., Wilmington

•  Saturday, Dec. 15: 9 a.m.-noon

To speed up the shopping and enrollment process, Delawareans are asked to bring these documents or information with them:

• Birth dates of those applying for coverage.
• Social Security numbers for those applying for coverage.
• Pay stubs, W-2 forms or other information detailing your family’s income.
• Policy or member numbers for any current health insurance plans.
• Information about any health insurance that is available to you or your family through a job.
• If you have previously enrolled on the Health Insurance Marketplace, bring your log-in and account information.

About 82 percent of those enrolled on Delaware’s marketplace for 2018 received tax credits to help pay their monthly premiums. For those eligible for financial assistance, the average premium after tax credits in 2018 was $122 per month. Financial help is available to individuals with an annual household income up to $48,560 and up to $100,400 for a family of four.

“Many people don’t realize that they may be eligible for tax credits to help pay their monthly premiums,” Secretary Walker said. “If you are uncertain about your eligibility based on your annual household income, it’s best to contact a local enrollment assister to help walk you through the process, and explore your options.”

For 2019, Highmark Blue Cross Blue Shield of Delaware is the only insurer on Delaware’s marketplace, offering a total of eight plans for individuals and families – one gold plan, three silver, two bronze, one catastrophic and one platinum. The metal categories are based on how enrollees choose to split the costs of care with their insurance company. Bronze plans have low monthly premiums, but higher out-of-pocket costs when you need care; gold plans have high premiums, but lower out-of-pocket costs when you need care.

Two insurers – Delta Dental of Delaware, Inc., and Dominion Dental Services, Inc. – offer a total of 11 stand-alone dental plans, five with a low actuarial level (70 percent) and six with a high actuarial level (85 percent).

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

After open enrollment ends Dec. 15, Delawareans can enroll in coverage only if they experience a life event that qualifies them for a special enrollment period. Among the many qualifying life events are birth or adoption of a child, a permanent move, loss of other coverage through your job, and marriage.

NEW CASTLE (Dec. 22, 2017) – Despite significant challenges to enrollment, almost 25,000 Delawareans signed up for coverage for 2018 on Delaware’s Health Insurance Marketplace. The enrollment total was about 10 percent lower than the 27,584 who signed up last year.

On Thursday, the Centers for Medicare and Medicaid Services (CMS) released Delaware’s enrollment total of 24,860 for the six-week enrollment period that ended Dec. 15. This year’s enrollment period – the fifth year for open enrollment – was half as long as it was last year. Nationally, almost 9 million people signed up for coverage in the 39 states that use HealthCare.gov for the online enrollments.

“I am pleased that so many Delawareans saw the value and the need in having health insurance coverage despite the challenges they faced this year during open enrollment,” Governor John Carney said. “Health insurance provides that critical connection to quality health care. That connection is the first step toward building a healthier Delaware.”

Earlier this year, Aetna announced it would not sell plans on Delaware’s Health Insurance Marketplace for 2018 leaving Highmark Blue Cross Blue Shield of Delaware as the only insurer on the marketplace. That meant enrollees who had coverage through Aetna Health or Aetna Life for 2017 had to choose one of seven Highmark plans that were available for purchase in 2018 or they were automatically enrolled in a similar plan offered by Highmark. In October, just before the start of open enrollment on Nov. 1, Insurance Commissioner Trinidad Navarro announced that the Department of Insurance had approved an average rate increase of 25 percent for Highmark’s plans for 2018.

“I am grateful that we were able to get out the message to Delawareans that health insurance is important to have and that financial assistance was available to help them pay for it,” said Department of Health and Social Services (DHSS) Secretary Dr. Kara Odom Walker, a board-certified family physician. “Our federal navigators, enrollment assisters and insurance agents and brokers did an outstanding job of working with people to help them understand their options, including the availability of federal financial assistance.”

During 2017, more than 81 percent of Delaware enrollees received financial assistance, including tax credits, which help to reduce the cost of monthly premiums. The percentage of Delawareans who received financial assistance for 2018 is not yet available. Financial help was available to individuals with an annual household income up to $47,520 and up to $97,200 for a family of four. CMS plans to release a full enrollment report in March.

“Despite the challenge of a much shorter enrollment period and little funding for marketing, Delaware still enrolled thousands of people who may not otherwise have been able to get covered,” said U.S. Senator Tom Carper. “I will continue my work to strengthen the health insurance marketplace and bring down the cost of healthcare for all Delawareans.”

In addition to insurance agents and brokers, Westside Family Healthcare, Chatman LLC, Henrietta Johnson Medical Center in Wilmington and La Red Health Center in Georgetown provided one-on-one enrollment assistance. Those assisters now will help people who have questions about using their health insurance and they also can help people who qualify for a special enrollment. Individuals who experience a life-qualifying event such as the birth or adoption of a child, marriage or divorce, moving from one state to another, or losing coverage through employment are eligible to shop for and enroll for coverage on the health insurance marketplace outside of the open enrollment period. To learn more about special enrollments, go to HealthCare.gov. 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 have received coverage under the Medicaid expansion. To be screened for or to apply for Medicaid benefits, go to Delaware ASSIST.

“Access to quality healthcare is the foundation for healthy communities,” said Delaware Insurance Commissioner Trinidad Navarro. “Notwithstanding the obstacles during the shortened open enrollment period, Delawareans made clear their willingness to participate in the Affordable Care Act. I commend the efforts of DHSS and the navigators who assisted consumers. I also thank the federal delegation for their efforts to try to extend the signup period.”

Under the Affordable Care Act, individuals who can afford health coverage, but who choose not to buy it are subject to paying a penalty when they file their federal tax return for the year they don’t have coverage. For 2017, the fee will be equal to the higher of these amounts: 2.5 percent of annual household income or $695 per adult, plus $347.50 for each child under 18. The maximum amount is $2,085 per household. In addition to the fee, consumers will be responsible for the total cost of any health care expenses they incur. Under the tax cut just passed by Congress and awaiting the signature of President Donald Trump, the individual mandate will be repealed beginning for the 2019 tax year.

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The Department of Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.

WILMINGTON, Del. – Governor John Carney on Friday released the following statement after President Trump’s decision to end federal cost-sharing reductions that make health insurance and health care affordable for low-income Delawareans:

“President Trump’s decision to end cost-sharing reductions will hurt thousands of low-income Delawareans who use those subsidies to make their health insurance and health care affordable. Less than three weeks away from the start of open enrollment on Delaware’s Health Insurance Marketplace, the President’s action will lead to thousands of Delawareans deciding that health insurance is no longer affordable for them and their families. That will lead to more people being uninsured in our state, which eventually means increased premiums for all of us. Ultimately, these changes could lead to insurers deciding to leave the Delaware market. That’s bad for health care in Delaware, bad for the health of Delawareans and bad for the economy of our state. My administration will work with our Congressional Delegation to restore the cost-sharing reductions as soon as possible.”

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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

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