NH State Representative Steven Smith

Now that open enrollment for plans on the Health Insurance Marketplace (a.k.a exchange) has begun,  we thought we’d put together some basic information in the event your constituents have questions about the who/what/when/where of Obamacare.

*This is not an endorsement of the law. It is to help answer common questions. Most of the information was derived from official sources, however, this should not be construed to be official instructions. Individuals are encouraged to do their own research and seek further information from official sources.

Who needs to sign up for coverage under Obamacare?

You’re considered covered if you have Medicare, Medicaid, CHIP, any job-based plan, any plan you bought yourself, COBRA, retiree coverage, TRICARE, VA health coverage, or some other kinds of health coverage. (Healthcare.gov)

If none of the above situations apply, go to Healthcare.gov to go through the application process.

If you’re eligible for job-based insurance, you can consider switching to a Marketplace plan. But you won’t qualify for lower costs based on your income unless the job-based insurance is unaffordable or doesn’t meet minimum requirements. You also may lose any contribution your employer makes to your premiums. (Healthcare.gov)

If you have Medicare, you’re considered covered and don’t have to make any changes. You can’t use the Marketplace to buy a supplemental or dental plan. (Healthcare.gov)

Where do NH citizens go to sign up for coverage?

Call 1-800-318-2596 or go to HealthCare.Gov  – Both are operated by the federal government.

How long is the initial enrollment period?

Open enrollment began October 1 and will last through March 31, 2014.

If you enroll by December 15, 2013, coverage can begin as soon as January 1, 2014.

When is the next enrollment period?

Oct. 15, 2014—Open enrollment on the health exchanges for coverage in 2015 begins. In future years, Oct. 15 also will be the opening of enrollment for coverage.  

Dec. 7, 2014—Open enrollment for 2015 coverage closes. In future years, Dec. 7 also will be the closing date for enrollment.

What is the penalty for not enrolling in coverage?

If you don’t have coverage in 2014, you’ll have to pay a penalty of $95 per adult, $47.50 per child, or 1% of your income (whichever is higher). The fee increases every year. Some people may qualify for an exemption to this fee.

In you don’t have coverage by Jan 1, 2015, you must pay a penalty of $325 for individual adults or 2 percent of income, whichever is higher.

Where can I find information on rates and subsidies?

Go to HealthCare.gov or visit the website of NH’s only provider current of plans on the exchange, Anthem, at www.anthem.com

I own a business. What are my requirements under Obamacare?

If you have over 50 employees:

Jan. 1, 2015—Employers with 50 or more full-time workers must offer affordable, comprehensive insurance by this date or face penalties of $2,000 per employee. (Healthcare.gov)

If you have under 50 employees:

Small businesses may get health coverage in the Small Business Health Options Program (SHOP) Marketplace.

Starting in 2014, businesses with 50 or fewer full-time equivalent (FTE) employees can use SHOP to offer coverage to their employees. This applies to non-profit organizations as well. You control the coverage you offer and how much you pay toward premium costs.

If you insure your employees now, you can keep the coverage you have. If you have 50 or fewer full-time employees, you may offer a plan via SHOP instead.

If you have other business related questions, it’s best to consult your current provider or healthcare.gov

I’ve heard that plans offered on the exchange/marketplace have a “narrow” network of providers. Is that true?

Yes. As of 2014, the only plans being offered on the exchange will be through Anthem and will utilize a smaller network of hospitals and physicians. Only 16 of the state’s 26 hospitals and about 85% of the state’s primary care physicians will be in the network. Anthem has stressed that for emergency and specialty care, there will be opportunities for out of network referrals. In 2015 it is likely that there will be competing plans offered on the exchange that may offer other provider network options.

CONSUMER ALERT
Attorney General Joseph A. Foster and the Public Utilities Commission’s Director of Consumer Affairs Amanda O. Noonan warn New Hampshire utility customers about a scam currently operating in the state. A number of consumers have complained of receiving calls from individuals pretending to be with the customer’s utility company. The caller says that the customer has a past due balance on his or her utility account and then threatens the customer with disconnection of the utility service unless the delinquent amount is paid. Typically, the calls are made to small business customers late in the day and the customer is given only a few hours to make the payment. These calls are not coming from New Hampshire utility companies. Utility customers who are scheduled for disconnection due to nonpayment receive written notice a minimum of 14 days prior to any proposed disconnection date and the notice includes information about action they can take to maintain service.
Consumers receiving these types of calls should not provide any type of financial information to the caller, including credit card or bank account information, and should not make any payment.

Calls should be reported to the Public Utilities Commission at 1-800-852-3793.

Consumers can also call the Attorney General’s Consumer Hotline at 1-888-468-4454.

I was listening to an interview detailing all the federal employees who will stop being paid if the government shuts down. Question – Since the government would shut down because our Congress has failed to discharge their duties and pass a budget for 3 years now, why aren’t they first on the list? Forget these continuing resolutions. When Congress does not discharge one of their most basic duties and protect the stability of the American economy, they should stop being paid and have THEIR budgets frozen until they do. They should also use what we call here a “Call of the House”. In your NH legislature, when we have a deadline and we are at risk of not hitting it, they can lock us in until we do our work. Washington could learn a lot from NH. – Steve