WILMINGTON — Delaware will launch the third open enrollment period of its Health Insurance Marketplace on Sunday, ready to build on the first two seasons in which more than 23,000 Delawareans enrolled in private health plans and activated their coverage.
Open enrollment for health coverage in 2016 runs from Nov. 1 through Jan. 31 on HealthCare.gov. Individuals must sign up by Dec. 15 for coverage to be effective Jan. 1. Policies for all current enrollees expire Dec. 31.
Individuals enrolled this year can renew their current plan or enroll in a different plan for 2016. While insurance companies automatically will renew many consumers’ coverage, individuals who bought a marketplace plan are encouraged to go to HealthCare.gov to update their household income and other personal information, review their current coverage and check out the new plans among the 29 individual plans offered for 2016.
“Beginning Nov. 1, more Delawareans who previously were denied coverage because of a disability or other pre-existing condition, or who thought health insurance was beyond their monthly budgets, will have the chance to join thousands of their neighbors who are enjoying the peace of mind and possibility of improved health that come with being covered,” Department of Health and Social Services Secretary Rita Landgraf said.
The Health Insurance Marketplace in Delaware for 2016 will include:
• More choice: Individuals who are enrolling for the first time or re-enrolling will have more plans to choose from: 29 plans vs. 25 in 2015. Highmark Blue Cross Blue Shield, Aetna Health and Aetna Life Insurance administer the plans. A dozen dental plans will also be available.
• Health benefits that include coverage of pre-existing conditions, outpatient care, emergency services, hospitalization, prescription drugs, mental health and substance use disorder services, lab services and pediatric services.
• Rate changes: Individual-plan premiums will increase an average 22.4 percent for Highmark plans and less than 17 percent for Aetna.
• Small business employers: Owners will have 15 Small Business Health Options Program plans to choose from for 2016 versus 16 in 2015. Premiums will decrease 0.5 percent to 1 percent for Aetna plans and increase 12.7 percent for Highmark plans. Small business owners can enroll in SHOP at any time.
• Federal tax credits that in 2015 helped to lower the cost of coverage for 84 percent of Delawareans who enrolled. Their average monthly tax credit was $260.
• A new and improved ChooseHealthDE.com, Delaware’s official source of information about the Health Insurance Marketplace and connection to HealthCare.gov, the federal enrollment site. The new site, launched Thursday, has a cleaner look and improved navigation. A penalty calculator lets visitors it could cost for to see for going uninsured.
• A higher penalty for going uninsured. Those who are not exempt and do not buy insurance for 2016 will pay $695 per adult (plus $347.50 for each child younger than 18 not covered) or 2.5 percent of their household income, whichever is higher.
• Free in-person enrollment assistance from federally funded and trained specialists at several Delaware organizations, including Westside Family Healthcare, Chatman LLC, Henrietta Johnson Medical Center and La Red Health Center. State-licensed insurance agents and brokers also are available to assist individuals and employers with their enrollments. Go to www.ChooseHealthDE.com for details.
• A faster, smoother and safer enrollment process on Healthcare.gov that includes new features such as a calculator that estimates total costs — deductible, co-pays, cost-sharing — based on the plan and a consumer’s expected medical needs; a simplified re-enrollment process; and a “privacy manager” that gives users more control over the information they choose to share.
About eight out of 10 current enrollees will be able to buy a 2016 plan with premiums less than $100 dollars a month after tax credits, and about seven out of 10 will have a plan available for less than $75 a month, according to the U.S. Department of Health and Human Services.
In addition to the Health Insurance Marketplace, some residents might be eligible for coverage though Delaware’s expanded Medicaid program, which is open year-round. More than 9,000 individuals have received coverage under the Medicaid expansion. To be screened for or to apply for Medicaid benefits, go to Delaware ASSIST.
For more information, go to www.ChooseHealthDE.com or call (800) 318-2596, TTY: (855) 889-4325. You can enroll in marketplace coverage at www.HealthCare.gov or through an agent or broker, with no charge to the individual.