Ted Haynes, president of Blue Cross and Blue Shield of Oklahoma, discusses enrollment on and off Oklahoma’s federally-run health insurance marketplace.
Q&A with Ted Haynes
Q: How many people signed up with Blue Cross and Blue Shield of Oklahoma during the Oct. 1-March 31 enrollment period under the Affordable Care Act (ACA)?
A: About 85,000 Oklahomans chose Blue Cross and Blue Shield of Oklahoma as their health insurance carrier during the first open enrollment period. Roughly 60,000 people bought on the health insurance marketplace, and about 25,000 bought directly with us.
Q: What were the most popular plans?
A: About 57 percent chose Silver plans, while 29 percent selected Bronze plans and 14 percent enrolled in Gold Plans. The popularity of Silver plans is due, in part, to the fact that if individuals are eligible for cost-sharing subsidies, because their income is below 250 percent of federal poverty level, they must choose a silver-tier plan to get the subsidies.
Q: Are individual ACA-compliant policies available now? I heard you have to wait until next year’s open enrollment, Nov. 15, to get them?
A: If you’ve had a qualifying “life event” within the past 60 days, you may be able to enroll during the April 1 through Nov. 14 special enrollment period. Qualifying life events include moving to a new area that offers you different plans or isn’t covered by your provider network; marriage; birth or adoption of a child; losing health coverage due to job loss or a decrease in work hours; your income changes or some other event changes your income or household status. For a full list of qualifying events, visit bcbsok.com. The date your coverage starts is based on your life event and the date you apply. Depending on your income, you may qualify for Medicaid or the Children’s Health Insurance Program (CHIP). There is no special enrollment period for these government-offered coverage options — you can apply at any time.
Q: What about American Indians? Are there special enrollment periods for American Indians?
A: American Indians can enroll every month when signing up for coverage on the health insurance marketplace. Federal financial assistance may be available to help pay for premiums, depending on the household income. If American Indians buy coverage through the marketplace, they may not have to pay copays or other out-of-pocket costs when medical care is received from Indian Health Services (IHS) or through referral under Contract Health Services. To qualify for this, household income cannot exceed 300 percent of the poverty level, or roughly $70,650 for a family of four in 2013.
Date: May 8, 2014
Source: NEWSOK