By Traci Moyer
The Herald Bulletin
ANDERSON, Ind. —
Today, the federal Affordable Care Act opens its marketplace, and while the shopping frenzy for insurance bargains may have begun, not everyone is prepared for the anticipated crush of shoppers.
Deborah Hester, owner of Plus One Enterprises, Anderson, will be one of the many navigators across the state assisting people with insurance enrollments. But she won't be ready to offer assistance until after Oct. 17.
“I know that’s terrible, but that is just how it is,” Hester said.
Hester signed a lease for an office space in Anderson on Monday and said she can be reached at (855) 758-7166, but her website is still in the design process.
“We are not up and running yet,” she said. “I can’t do enrollments until I am done with my licensing. But I can answer any questions.”
Dennis Rosebrough, communications director for the Indiana Department of Insurance, said 97 certified navigators and about 155 people in the process of being licensed by the state will provide the federal services.
According to the federal government, navigators will assist people shopping or enrolling in the Health Insurance Marketplace. Only those specially trained and certified, such as navigators, application assisters, certified application counselors, insurance agents and brokers, and government agencies, are qualified to assist people with federal health coverage and enrollments.
Grants were awarded to several qualifying navigators in Indiana to provide the services. Hester received a one-year federal grant in August for $130,875.
Rosebrough said, along with satisfying federal requirements, navigators in Indiana must complete a state program in addition to training, testing and background checks.
“The federal government is running the marketplace in Indiana,” Rosebrough explained.
Each state was given the option to administer the Marketplace or have the program run by the federal government. Indiana opted to have the federal government administer the program. That means all enrollment and coverage options in the state must be accessed through federal portals at www.healthcare.gov.
The Herald Bulletin visited the federal site on Monday and used the Health Insurance Marketplace Live Chat feature to inquire about local navigators. It took more than eight minutes for the online assistant to provide contact information for an Indianapolis company.
There were no local offices available.
“One of the things that is a little frustrating — the federal government has not done a very active public outreach in Indiana,” Rosebrough said. “People are confused and don’t know where to go for the information. People are calling us, and the fact is, it is not our show.”
Rosebrough said the state reviews insurance products for the Marketplace. But only four providers have opted to enroll in Indiana, and only three providers are offering coverage to residents in Madison County.
Anthem is covering all 92 Indiana counties, but each of the other three companies are covering only 31 of the counties, he said. In Madison County, customers can purchase plans for 2014 from Physicians Health Plan (PHP), Anthem and MDWise. Residents can purchase health insurance through private companies not listed in the Marketplace, but they will not be eligible for taxpayer subsidies.
The subsidies apply to families and individuals who have an income between 100 and 400 percent of the poverty level.
Hester said she plans to operate an office at 3320 S. Main Street, Suite A, in Anderson and a second location — yet to be determined — in Muncie. She said she will be in Anderson on Mondays and Tuesdays and in Muncie on Thursdays and Fridays. Hester plans to conduct outreach seminars on Wednesdays and Saturdays after she has been licensed.
“I don’t foresee any trouble,” she said.
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How to enroll for health-care insurance under the Affordable Care Act:
1. Set up an account at www.healthcare.gov.
2. Fill out the online application. You'll provide information about you and your family, income, household size, current health coverage and more. This will help the Marketplace find options that meet your needs.
3. Compare your options. You'll be able to see all the options you qualify for, including private insurance plans and free and low-cost coverage through Medicaid and the Children’s Health Insurance Program (CHIP). The Marketplace will tell you if you qualify for lower costs on your monthly premiums and out-of-pocket costs. You’ll also see details benefits to help you choose a plan.
4. Enroll at www.healthcare.gov. After you choose a plan, you can enroll online and decide how you pay your premiums to your insurance company. If you or a member of your family qualify for Medicaid or CHIP, a representative will contact you to enroll.