FARGO – Those who want health insurance coverage next year through the new online marketplace should take note: The sign-up period begins Saturday and ends Feb. 15.
But those who want to start new coverage or change insurance plans next year must enroll by Dec. 15 to ensure that coverage begins Jan. 1.
All of which is to say that a new round of enrollment under the Affordable Care Act, the hotly contested health reform law passed in 2010 and often called Obamacare, is about to begin.
Last year’s rollout of the marketplace was famously rocky, bedeviled by technical glitches and frustrating sign-up delays, but officials say this year’s enrollment should be a smoother ride.
“I think it’s reasonable to be confident that it will work much better than last year,” said Mike Fierberg, a regional spokesman for the Centers for Medicare and Medicaid, which oversees implementation of the health care law.
That said, he added, the computer network used to enroll health insurance consumers, compare plans and integrate financial information has a lot to handle.
“It’s a great big, complex technical system,” Fierberg said, adding that it can be overloaded during periods of peak demand, when consumers can be placed in a “waiting room,” and can provide their phone number or email to be contacted when the crunch has passed.
“In times of very high demand, we’ll queue people in,” he said. “That said, I think it should be a much improved consumer experience this year.”
The new marketplace is up and running, so consumers can go online to do comparison shopping to be ready for enrollment.
North Dakota is one of 34 states that decided to have the federal government run the health insurance marketplace, accessible online at www.healthcare.gov.
Minnesota created its own marketplace for health coverage, MNsure, available online at mnsure.org.
Assistance also is available through trained “navigators” who can answer consumers’ questions about how to navigate the system to enroll for coverage. To find local navigators, go online to localhelp.healthcare.gov.
Here are a few reminders to bear in mind, and a few new wrinkles that take effect with the new enrollment period:
- Consumers can stay enrolled in their current health plan. If an enrolled consumer does nothing, coverage is automatically renewed after Dec. 15 to ensure coverage continues starting Jan. 1.
- It’s important for currently enrolled consumers to update personal information, including any changes in income, address or family circumstances, such as a birth or marriage.
- Penalties for those who fail to get health insurance coverage – a provision called the individual mandate – will go up next year. The penalty will be $325 for individuals and or 2 percent of a household’s adjusted gross income, whichever is greater. The goal of the Affordable Care Act is to boost insurance coverage by expanding Medicaid and to offer premium subsidies through tax credits for those who qualify based on income eligibility. To contain premium costs, it’s important to enroll younger, healthier consumers, so the insurance pool isn’t dominated by older, sicker people – hence the mandate to compel compliance.
- Next year, for the first time, coverage will be available through an optional program tailored to allow coverage of workers of small businesses with 50 or fewer employees.
The so-called SHOP – Small business Health Options Program marketplace – is intended to be flexible to meet the needs of small businesses and offers tax credits to help cover their workers, Fierberg said.
“I’d say we’re cautiously optimistic that open enrollment will be a better experience for customers this year,” said Luther Stueland, director of health policy impact for Blue Cross Blue Shield of North Dakota.
Three health insurers cover more than 11,384 people in North Dakota, with 9,126 covered by Blue Cross Blue Shield of North Dakota, 1,780 covered by Medica and 478 by the Sanford Plan, according to figures from the North Dakota Department of Insurance.
The process should be simpler than last year, officials have said, and re-enrollment for those whose circumstances haven’t changed should go especially smooth, said Ruth Krystopolski, president of the Sanford Plan.
“For some of those folks it’s going to be really easy,” she said. Still, she added, “We’ve never done a re-enrollment before. That’s making us a little anxious.”