'Obamacare' comes into focus for AK

Rates among the highest and the lowest in the nation, depending on annual income

It’ll be Oct. 7 before Central Peninsula Hospital has brokers assisting some of the thousands of community’s uninsured adults and children with health insurance enrollment.

 

From a hub in the medical center, brokers from Enroll Alaska, a private company, will work with people looking for help enrolling in insurance plans now required by Affordable Care Act, also known as “Obamacare.”

Aside from enrollment help at CPH, people can begin signing up for insurance online as soon as Tuesday.

According to the Department of Health and Human Services report compiled in mid-September, a single 27-year-old Alaskan earning $25,000 annually will pay between $312 and $48, depending on the level of insurance sought and income. A family of four making $50,000 a year will pay between $1,131 an $0 per month depending on the quality of insurance sought.

Prices for plans in Alaska range from the second highest nationally, only behind Wyoming, to the absolute lowest prices for low-income residents.

The service at CPH is just one way that Peninsula citizens and legal residents can access healthcare plans on the state’s Federally-facilitated Marketplace, set up by the federal government after Gov. Sean Parnell chose not to have Alaska build its own exchange.

Also available to help people work through the new system and enroll for healthcare are United Way navigators, the statewide 2-1-1 system, healthcare.gov and direct communication with the two providers that have decided to take on Alaskans and small businesses — Premera Blue Cross and Moda Health.

The federal government spent $67 million across the nation to fund navigators — $300,000 of it in Alaska, which will fund four navigators to cover the enitre state.

One thing to remember, said Sue Brogan, vice president of income and health at United Way of Anchorage, is that not everyone has to get signed up for insurance on Oct. 1.

People should take their time to learn about the plans, subsidies and tax credits in effort to decide which plan best serves them. There are 90 days to sign up during the first enrollment period, Brogan said.

Different than the United Way Navigators, who are restricted to explaining the enrollment process alone, brokers working from CPH will be able to give their opinion and direct advice on which plan — including the details of subsidies and tax breaks — best suits the individual, said Shanda Hall, Central Peninsula Hospital revenue cycle director.

According to the Alaska Department of Commerce, Community and Economic Development Division of Insurance those who do not maintain minimal coverage will face penalties for every uninsured month starting in January 2014. Companies with less than 50 full-time employees will not be required to offer health plans. Those with more than 50 employees have to provide plans and can be fined if one employee obtains coverage through an exchange.

Penalties per month for each individual in the household not maintaining insurance will range from $95 in 2014 to $325 in 2015 to $695 in 2016 and beyond. There is a cap of three penalties per month per household with some exceptions for penalties based on income.

Minimal coverage is defined by the Congressional Research Service as Medicare part A; Medicare Advantage; Medicaid; State Children’s Health Insurance Programs; TRICARE; the VA Healthcare Program and employer sponsored plans.

Residents on the Peninsula who use the CPH brokers stationed at the hospital will not be charged for the broker’s services. Enroll Alaska will earn its fee from the insurance companies, Hall said.

According to Kaiser Family Foundation, a non-partisan non-profit source on healthcare policy and issues, about 58 percent of Alaskans without insurance as of Oct. 1 will qualify for some form subsidy.

The main form of help paying for insurance, for those who qualify, will be through the Premium Tax Credit which can either be paid directly to the insurance company and reduce the monthly bill or taken at the end of the year when taxes are done.

Tax credits and subsidies for insurance will depend on the size of household and the household income, ranging from no cost to those at 78 percent of the federal poverty level (FPL) to 400 percent above the FPL. Those at 78 percent or below the FPL will likely qualify for Medicaid and have no costs for insurance and those at 400 percent of the FPL — $117,000 for a family of four in Alaska — will pay no more than 9.5 percent of their income, about $926 per month for the family.

The brokers at CPH will enroll new insurance clients with both Moda and Premera Blue Cross, the only two providers to sign on for Alaska.

An additional advantage of the broker is that once the insurance is purchased, people will have access to the broker for questions and issues later, hall said.

Hall said that brokers were equally affiliated with both providers. There should be no bias for one company over another, she said.

The brokers are not working for the hospital and there is no financial gain to the hospital. It’s just a community benefit, Hall said.

Reach Greg Skinner at greg.skinner@peninsulaclarion.com

 

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