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What you need to know for 01/18/2018

Health-plan deadline looms

Health-plan deadline looms

The deadline for most people to get coverage through the state and federal health exchanges is Monda

The deadline for most people to get coverage through the state and federal health exchanges is Monday, and local insurers say they’re prepared for the enrollment surge expected this weekend.

As of Tuesday, six days before the deadline, more than 717,000 New Yorkers had enrolled in the New York marketplace, also known as New York State of Health, and nearly 4,000 small businesses had enrolled their employees in the exchange, which opened in October 2013. Most of the people who enrolled had no previous insurance.

CDPHP, an Albany-based health insurer, has opened a call center with expanded hours and extra staff in anticipation of the Monday deadline. MVP Health Care, of Schenectady, has added extra enrollment sessions and is assigning more counselors to work after hours in several locations across the Hudson Valley.

“We have also been very proactive in reaching out to the public, reminding them of the March 31 deadline,” said CDPHP spokeswoman Ali Skinner in an email.

Many have wondered if New York would extend its open enrollment deadline after the Obama administration announced earlier this week that it would extend the deadline for anyone who had technical difficulties with the federal health exchange website. Federal officials said Tuesday that anyone who began to apply for coverage on but does not finish by Monday can seek an extension through mid-April.

It appears New York is following suit, developing a process to help individuals who have been locked out of the state’s exchange website due to technical difficulties. But the process of requesting an extension at the state level is a little less clear. New York State of Health is planning to issue written guidance soon, according to CDPHP’s Chief Strategy Officer Bob Hinckley.

The individual mandate requires most Americans to get health coverage by Monday or pay a penalty that will increase over the years. Those who miss the deadline and don’t qualify for an extension will have to pay a 2014 fine of $95 per adult and $47.50 per child or 1 percent of family income, whichever is greater.

State officials say the average premium for an individual in New York costs about half as much as it did before the exchange, and preliminary studies seem to confirm that.

“Because New York’s individual market was priced so high prior to the Affordable Care Act, those moving into the marketplace are seeing a significant savings,” said Skinner.

It’s yet unclear how average premiums have changed for small businesses enrolled in the New York exchange.

“It’s an apple-to-oranges comparison,” she said. “The products and benefits have changed so much because of ACA requirements, you can’t compare small group prices today to one year ago.”

CDPHP offers more than a dozen plans for small groups shopping on the exchange — three products across each tier (bronze, silver, gold and platinum) plus a catastrophic-coverage plan. It offers a total of six plans for individuals, with about one to two different products per tier. So far, the most popular plans have been on the silver tier.

MVP Health Care merged with the Tarrytown-based Hudson Health Plan in May 2013 to bolster each organization’s strengths in the wake of a changing health care landscape. One of the benefits for MVP was the addition of Hudson’s expertise in community-based individual enrollment.

To accommodate the rush of people trying to make Monday’s deadline, Hudson Health Plan is opening its Tarrytown, Newburgh and Monticello offices on Saturday and has 40 certified application counselors to help Hudson Valley residents apply for insurance through the online exchange. These counselors can enroll people in any plan, and work with them in one-on-one sessions that can last up to 21⁄2 hours.

“By starting the process before the 31st, you’ll be doing yourself a big favor, since applications begun before the end of the deadline will be granted a grace period to complete,” said MVP Executive Vice President of Corporate Affairs Georganne Chapin in an email.

Last-minute enrollees can compare insurance options, calculate costs and select coverage at the New York State of Health website at or call the Customer Service Center at 1-855-355-5777.

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