For Health insurance: Be Engaged and Get Covered

For Health insurance: Be Engaged and Get Covered

By Sheila Talty, SVP, Individual and Small Group Sales, Empire BlueCross BlueShield

Leaves are falling, football fans are thinking playoffs and conversations are turning to holiday planning. But for many New Yorkers, this season marks another important milestone: open enrollment for health insurance coverage. Last year, nearly 1 million New Yorkers obtained health insurance from the New York State of Health marketplace or exchange. As we move into the second year, Empire BlueCross BlueShield wants to help more consumers get the insurance coverage they want and need.

To get the best coverage, at the best price, New Yorkers need to be actively engaged in the process; they need to pay attention to upcoming key dates, shop around and compare, and if necessary, turn to knowledgeable experts and resources.

Unlike “Black Friday” that crams shopping and crowds into one day, open enrollment lasts three months. It begins on November 15 and ends on February 15, 2015. However, consumers should not wait until the last minute: in order to get coverage starting on January 1, 2015, New Yorkers need to choose a plan by December 15. During the open enrollment timeframe, consumers can use the exchanges to do comparison shopping on things such as monthly premiums, coverage options and providers, out of pocket costs such as co-pays, deductibles and co-insurance.

Why is it important to be engaged this year? For consumers who qualify for tax credit and/or cost share subsidies, they can find an affordable plan, in some cases getting coverage at no cost. For consumers who bought coverage through the exchange last year and received a subsidy, they should update their personal information, such as income and dependents, to help make sure they get the right financial assistance for their healthcare insurance coverage for next year. You don’t want to owe the Internal Revenue Service money in 2016 for a miscalculated subsidy or pay more than you have to throughout the year.

At Empire we want to make the enrollment experience easier for consumers. Since last winter, we have collected important consumer feedback to make the process easier this year. But we know and recognize there continue to be possible areas of confusion. A recent survey reported 9 out of 10 Americans were unaware open enrollment starts this month and two-thirds indicated they knew “only a little” or “nothing at all” about the marketplaces. Just over half (53 percent) of the uninsured are unaware of the financial assistance available to help low- and moderate-income individuals purchase insurance.

If you are one of these New Yorkers – or know a family member or friend who may need help – there are places to turn for answers. A good starting place is to visit www.empire.com or for renewing members, www.changemycoverage.com, to get subsidy estimates, provider information and plan recommendations. If you have questions to ask, Empire has a team of highly-trained experts, telesales agents from licensed Health Plan Advisors for existing members, to answer questions and guide members and customers through the process. Given last year, more than one million people called our call centers in a 48 hour timeframe – more than 100 times its normal call volume, we have increased our call center capacity to help consumers this year.

While some health insurance providers did not participate in New York’s exchange market last year, Empire was an essential player and learned valuable lessons from the launch of the exchange. We know there were frustrations last year, but also believe that for New Yorkers just a few hours over the next month choosing a health insurance plan will be time well spent and one of the most important decisions you make for the coming year.