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State healthcare insurance exchange board updates community as deadline rolls closer

By Kaitlin Loukides
Published On: Jul 11 2013 08:19:35 PM CDT
Updated On: Jul 11 2013 08:35:49 PM CDT

What you need to know about the state healthcare exchange plan as it unfolds.

POCATELLO, Idaho -

For those who do not yet have health insurance, the January 1 deadline to jump on a plan is rapidly approaching.

Chairman of the Idaho Health Insurance Exchange Board Stephen Weeg updated the community on Wednesday on the new advancements the board is making toward coming up with a concrete exchange plan before its October 1 deadline, and what Idahoans need to know before purchasing health insurance.

"The deadline is approaching, October 1 isn't that far away, but we've made a lot of progress," Weeg said.

Since the topic can be complex, the board will start a strong outreach program starting in late August. The board will appoint people called 'assistors' to help answer questions and show people how and where to apply in order to get on a health insurance plan that is right for them. 

The board will also launch a website to help guide people through the tedious details within the next few weeks. 

Here is a link to the current website where you can view the board's minutes, agenda, and even read-up on some of the complexities of the new state exchange program.

Weeg also said there is still a vast majority of people who do not yet have health insurance because they either cannot afford it, or they just do not find this a necessity.

"So it's not so much a matter of total disregard, it's more a matter of affordability for a lot of people...and if you're under 30, you have that sense of invincibility."

Although people who do not have health insurance yet should not be too worried, the final deadline for people to find that health insurance plan is March 31. On April 1, the penalties will start to kick in.

According to the national Affordable Care Act, starting in 2014, families will be charged $285 or 1% of their total income, while individual taxpayers will be charged $95 or 1% of their income. Every year thereafter, that amount will rise and can add up to a hefty sum after a few years.

Weeg said signing up for an insurance program through the state will be much cheaper versus signing with the federal Affordable Care Act.  To use the federal marketplace, the premium fee starts at 3.5% while the Idaho exchange starts at a 1.5% premium fee.

Another new aspect to the state's insurance exchange program will be the difference in premium levels. Weeg mentioned, in Idaho, the difference in premium prices between a young person and an older individual is five-to-one, meaning the older person's premium could be as much as five times as high as the younger individual's premium.

But the new law will state a three-to-one cap. This means those who are ages 55 to 60 will see a slight decrease in premium prices, but the younger pool of Idahoans might see their premium rise slightly higher.

But, don't get too excited quite yet.

There are various other factors these insurance companies will now have to consider. All of the things insurance companies never had to worry about when they were playing in the group market will now come into play. This includes: getting a raise, an addition to the family, a divorce, leaving your job for whatever reason, and anything else that might effect your tax credit.

So, now insurance companies will be able to look at your tax credit information in order to determine how much your premium will be and how much they will need to charge the federal government in picking-up the rest of the cost you won't be paying.

Confused? That's okay, just keep reading. If you already understand all of this, then disregard these next two paragraphs.

All you need to know right now is that depending on what your tax credit is, that will determine how much your premium bill will drop. The federal government will cover the rest. This means the insurance company will get two bills - one from the taxpayer and one from the federal government.

So, once an individual selects an insurance plan after shopping around the virtual marketplace (the exchange), that information will be sent to that specific insurance company, they will enroll the individual, and then the insurance company will send them the bill. Depending on the premium plan, the individual will pay the insurance company a portion of that bill, and the federal government will pay their share of the premium.

Weeg also said this new state-based exchange has created a tremendous influx of insurance companies who want to offer on the Idaho exchange than currently sell individual plans to any other degree. So with the increase of plans and carriers, the board is still trying to figure out which plans will show up on the exchange because now there are plans for individuals and small business employers.

In order to qualify for the federal exchange, families or individuals can earn incomes up to 400% of the poverty level. This year in 2013, this equates to a family of four earning an income of $92,200 each year.

Weeg said there are currently 190,000 Idahoans who will be needing to purchase healthcare insurance by the deadline. In other words, one out of every seven people living in Idaho will be shopping in the state exchange after it opens in order to escape those hefty penalties.

For more information on how these new Affordable Care Act laws will impact businesses, visit our story on that topic here: http://www.localnews8.com/news/new-affordable-care-act-laws-to-impact-employers/-/308662/20527384/-/9mas6v/-/index.html

To figure out what your tax credit might look like, visit this website here: http://kff.org/interactive/subsidy-calculator/

Follow Kaitlin on Twitter: @KaitlinLoukides



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