Began Nov. 1, runs to Dec. 15.
The open enrollment period for Delaware’s Health Insurance Marketplace started Nov. 1.
With the enrollment period only six weeks long and fewer assisters on the ground this year to help, Delawareans seeking coverage for 2019 are urged to sign up early in order to avoid any last-minute rush before the Dec. 15 deadline.
The federal government has announced planned maintenance shutdowns of HealthCare.gov on most Sunday mornings during open enrollment.
Open enrollment, when people can renew coverage or sign up for a new plan for 2019, runs from Nov. 1 through Dec. 15, at healthcare.gov. Coverage for enrollees who sign up by Dec. 15 and pay their first month’s premium will be effective Jan. 1.
Delaware currently has about 24,500 people enrolled for coverage through its Health Insurance Marketplace, 77 percent of whom re-enrolled for 2018 and 23 percent who were new. For 2018, about 82 percent of enrollees in Delaware were eligible for tax credits, which help reduce the cost of the premium.
Eight Highmark Blue Cross Blue Shield of Delaware plans are available to buy in 2019. Existing customers will be automatically re-enrolled in a plan that is similar to the one they currently have.
In August, Insurance Commissioner Trinidad Navarro announced that the Department of Insurance approved an average rate increase of 3 percent for 2019, the lowest increase since the marketplace began in 2014.
Federal tax credits are available for those whose household income is between 138 percent and 400 percent of the Federal Poverty Level. For 2018, that’s between $16,753 and $48,560 for an individual, or between $34,638 and $100,400 for a family of four.
Delawareans who need help enrolling 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, visit choosehealthde.com. Enroll in marketplace coverage at healthcare.gov or by calling 800318-2596.
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. Visit HealthCare.gov or call 800-706-7893.
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 care is needed; gold plans have high premiums but lower costs when care is needed. In a silver plan, the insurer pays about 70 percent of medical costs and the consumer pays about 30 percent, up to a maximum annual out-of-pocket cap of $7,350 for an individual and $14,700 for a family.
For 2019, Highmark Blue Cross Blue Shield of Delaware will offer one gold plan, three silver, two bronze, one catastrophic and one platinum. Two insurers — Delta Dental of Delaware Inc. and Dominion Dental Services Inc. — will offer 11 stand-alone dental plans on the marketplace, five with a low actuarial level at 70 percent and six with a high actuarial level at 85 percent.
Navarro said the 2019 rates are silver-loaded, which means the highest premium increases are found on those plans because greater federal tax credits are adjusted to offset the increases and reduce the net cost of premiums to enrollees.
Because of the increased federal tax credits received, silver-loading may result in reduced premiums for gold plans and low-cost or free premiums for some members who choose bronze plans.
Consumers who pick silver plans might qualify for additional savings through discounts on deductibles, copayments, and coinsurance. In Delaware, about 45 percent of current enrollees qualify for cost-sharing reductions. 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.
Starting in 2019, there will be no federal tax penalty for individuals who can afford coverage, but choose not to buy it. The penalty is still in force for 2018, and when people pay their 2018 taxes they will pay a penalty for not having health insurance that is equal to the higher of 2.5 percent of annual household income or $695 per person, $347.50 per child younger than 18. The maximum penalty will not exceed $2,085 per household.
Some residents might be eligible for coverage though Delaware’s expanded Medicaid, 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, visit assist.dhss.delaware.gov.