New Haven selected as ‘navigator’ for helping public with Obamacare [New Haven Register, Conn.]

Oct. 01--NEW HAVEN -- New Haven will be one of six "navigators" hired to help the public sign up for insurance under the Affordable Care Act, but a storefront office and the staff to do it will not kick in until later in the month.

In the meantime, residents anxious to find out whether they qualify for a subsidy tied to their income, or to get a look at the provider and hospital networks under the three insurance plans available through Access Health Ct should call 1-855-805-4325, which will be staffed from 8 a.m. to 8 p.m., or go online at AccessHealthCT.com.

City spokeswoman Anna Mariotti said New Haven will soon have a dedicated hotline of its own for information on enrollment and there will be information on the city website.

Access Health CT has been working for a year to get Connecticut's insurance exchange running and the kickoff around the country for the beginning of enrollment is Tuesday.

Coverage with either ConnectiCare, HealthyCT or Anthem Blue Cross and Blue Shield will be effective Jan. 1 for those who enroll by Dec. 15.

The initial open enrollment period for 2014 ends on March 31, 2014, after which residents will have to wait until Oct. 2014 to join one of the plans, which offer considerable subsidies to help with premium costs, and for some residents, help with co-pays and deductibles.

If you have a life change after March 31, such as losing your job, getting married or having a child, you can apply for insurance on the exchange after this date, where the subsidies may apply based on income.

Mayor John DeStefano Jr. said the city will eventually have more than 70 "assisters" to answer questions, hold health care fairs and staff an office at 55 Church St. to help people enroll in an insurance plan.

Many are existing workers who will be assigned part-time and have to go through 40 hours of training before participating.

New Haven will be responsible for serving all of New Haven County and will have staff that speak 33 different languages, getting help from such groups as Junta for Progressive Action, and others.

Legal immigrants have access to the insurance plans and the subsidies, if they qualify by income, but this does not apply to undocumented residents.

Persons who are not here legally, however, are encouraged to inquire about the insurance, as their citizen children are eligible.

"This is not a 'gotcha,'" said Kate Gervais, who is head of the "assister" program, as far as encouraging all residents to feel free to contact Access Health CT for information.

DeStefano said there are an estimated 20,000 city residents who don't have insurance out of about 322,000 uninsured in the state.

The mayor hopes the new federal program will eventually bring down costs to help large employers, such as the city, which spends $90 million annually on healthcare costs for its 12,500 employees, their dependents and retirees.

Residents are encouraged to sign up for email updates on in-person enrollment fairs in their area starting in October.

Generally, to enroll, residents have to provide birthdates of all family members to be covered; Social Security numbers of those who are signing on or document numbers for legal immigrants; citizenship or immigration status; tax returns for previous years; employer and income information for al members of a household to be insured, such as pay stubs or W-2 forms; policy numbers of current insurance information.

Gervais said those enrolling will be asked what they made in 2012, what they think they will earn in 2013 and what they project for 2014. She said the insurance will be based on the estimated 2014 figure. If the subsidy is greater than what is allowed based on your income, people will have to pay back the difference.

There also are insurance brokers who can recommend a plan and enroll residents at no additional charge. They can be contacted through Access Health CT.

The Affordable Care Act has expanded Medicaid coverage to childless adults with incomes up to 138 percent of the poverty level, or from $15,971 for an individual to $32,734 for a family of four.

If you qualify for Medicaid, you can opt to enroll in one of the private plans on the exchange, but you won't qualify for subsidies. Signing up Medicaid, however, is open year round.

Subsidies will be available for residents who earn up to 400 percent of the poverty level, which for individuals is a maximum of $46,000 and $94,000 for a family of four. The Affordable Care Act caps healthcare costs at 9.5 percent of modified adjusted income and Dr. Mario Garcia, director of the city's health department, said for many people it will be much less.

Garcia said residents can also get help with out of pocket expenses, like deductibles and co-pays, if their income is between 100 percent the poverty level, $23,550 for a family of four, and 250 percent of the poverty level, which, as an example, is $58,875 for a family of four.

This only applies, however, to those who buy a "silver" plan, which is the middle plan offered by each of the insurers, with the bronze plan the cheapest and the gold the most expensive, according to the Center on Budget and Policy Priorities.

The penalty for not buying insurance in 2014 is $95 per person or 1 percent of modified adjusted gross income, whichever is higher; That increases to $325 person or 2 percent of modified adjusted gross income, whichever is higher and $695 person in 2016, or 2.5 percent of income.

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