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NC fifth in Health Insurance Marketplace enrollment


Nationwide, 7.1 million people enrolled in health insurance plans during the Health Insurance Marketplace open enrollment period, which spanned from Oct. 1, 2013, to March 31, 2014. Federal and state-run marketplaces were established by the 2010 Patient Protection and Affordable Care Act.


In North Carolina, which opted to participate in the federal Health Insurance Marketplace, 357,584 people enrolled in Marketplace plans, and the enrollment period also added 58,007 people to the state's Medicaid rolls. The state was fifth in the nation in Marketplace enrollment totals.


Of those in North Carolina who enrolled in Marketplace plans, 24 percent were ages 55 to 64, 22 percent were 45 to 54, 19 percent were 35 to 44, 17 percent were 26 to 34, 11 percent were 18 to 25 and 7 percent were younger than 18, according to the U.S. Department of Health and Human Services.


Blue Cross and Blue Shield of North Carolina was among only two companies who elected to offer plans on the state's Marketplace. The company said in a May 8 statement that 232,000 North Carolina enrollees selected one of its plans. BCBSNC said it enrolled fewer consumers in the 18 to 34 age range (25 percent versus an anticipated 28 percent) and more consumers in the 35-54 (40 percent versus 34 percent) and 55-plus (29 percent versus 15 percent) ranges than it had planned.


"Not as many of the state's young and healthy enrolled as expected," the company said. "Younger, healthier customers are needed in the customer mix to offset the costs of older customers or those with chronic conditions." This could affect future premium costs, the company stated.



Originally published: 2014-05-12 15:32:24
Last modified: 2014-05-12 15:34:01

Marketplace enrollment still available to some consumers

by Anna Oakes

The open enrollment period for plans available through the federal Health Insurance Marketplace ended March 31, but some people may still be eligible to sign up.


Consumers with a "qualifying life event," a health plan up for renewal or who are currently receiving COBRA coverage are eligible to sign up for Marketplace plans via a special enrollment period, according to Eric Schneider, outreach and eligibility specialist for High Country Community Health.


Qualifying life events include the loss of employer-based coverage due to a dropped policy, job loss or divorce; a change in household size due to marriage, birth, etc.; and relocation, even within state lines.


"For those already enrolled in coverage through the Marketplace, a special enrollment period can generally be triggered through relocation, change in household size, and in some cases, income as well," Schneider said.


COBRA is the temporary federal health insurance plan offered to workers and their families who lose their health benefits due to job loss, a reduction in work hours, a transition between jobs and other circumstances.


Until July 1, those currently receiving COBRA coverage can terminate COBRA and be granted a special enrollment period to enroll in a Marketplace plan.


Normally outside of an open enrollment period, consumers would have to decline an offer for COBRA coverage and receive a special enrollment period based on lost employer coverage or wait until COBRA coverage is exhausted to receive the special enrollment period.


"Consumers should call the Call Center and inform representatives that they are calling about their COBRA benefits and the Marketplace," according to guidance from the U.S. Department of Health and Human Services.


In addition, consumers whose health insurance plans purchased outside of the Marketplace are coming up for renewal are also eligible to shop the Marketplace through a special enrollment period. Consumers will have 60 days from the renewal date to select a qualified health plan in the Marketplace. These individuals should indicate "loss of other coverage" on their Marketplace application.


A special enrollment period will also be granted individuals beginning or concluding a term of service with AmeriCorps, VISTA or the National Civilian Community Corps.


Schneider said individuals who need to file a hardship exemption to avoid a tax penalty for not having insurance can still do so. Individuals and families with incomes at or below 138 percent of the federal poverty level or without access to coverage at or below 8 percent of household income may receive a hardship exemption.


The 2014 federal poverty guideline is $11,670 for a single person or $23,850 for a family of four.


The next open enrollment period is Nov. 15, 2014, through Jan. 15, 2015.


"I will continue to be assisting people who need help getting coverage via special enrollment periods, need to file exemptions or just want general information," Schneider said.


For more information about the Health Insurance Marketplace, visit http://www.healthcare.gov or call Schneider at (828) 773-7297.