Updates on the. Open Enrollment for the Health Insurance Marketplace is ending soon…. Open enrollment ends on March 31 st , 2014. If you sign clients up for the marketplace from now until March 31 st , their coverage will begin on May 1 st , 2014.
Ryan White funded programs, including HIP, are not entitlement or required programs. If financially capable, individuals can choose to pay their own insurance premiums and/or cost shares. It may be helpful for these individuals to lower the metal level of their plan (e.g. from a platinum level to a bronze level) potentially making their premium costs more affordable.
Individuals have until 3/31/14 to enroll in a Marketplace plan for 2014. If they cannot afford the premium and/or cost share costs themselves and have a household income < 300% FPL, they can apply for assistance through HIP.
With the 2014 Marketplace Open Enrollment period ending 3/31/14, providers are encouraged to assist clients in signing up for the Marketplace plan that best suits their needs.
HIP has received approval from SHP to resume issuing checks to BCBS and LAHC for the payment of premiums.
If a client switched to another plan and would like to switch back to the plan they originally enrolled in, the client needs to check with the insurance company to find out if the plan has been effectuated yet. A plan can be effectuated whether or not payment was received.
Client can choose to become / remain uninsured with the understanding of the consequencesof being uninsured, suchas:
-Penaltyfor not obtaininghealth insurance*
-Being reliant on LDAP and the public health medical care system
-LDAP open enrollment is dependant on the availability of funding and is subject to the
possibility of restricted access, such as waiting lists.
*The penalty in 2014 is calculated in 1 of 2 ways. You’ll pay whichever of these amounts is higher:
1. 1% of your yearly household income. The maximum penalty is the national average yearly premium for a bronze plan.
$95 per person for the year ($47.50 per child under 18). The maximum penalty per family using this method is $285.
The fee increases every year. In 2015, it’s 2% of income or $325 per person. In 2016, and later years it’s 2.5% of income or $695 per person. After that, it is adjusted for inflation.
If you would have qualified for expanded Medicaid (0%-138% FPL), you’re exempt from the law’s requirements to buy coverage because Louisiana declined expansion.
Therefore, you won’t pay a penalty this year for not buying it. HOWEVER, this exemption must be applied for and a Medicaid denial letter is required for application.
138% FPL = $15, 856 for a single person household.
More information on penalty exemptions are available at www.healthcare.gov/exemptions
Effectuated is a term used by insurance companies that means a plan has become active or gone into effect.
This information is available on lahap.org
Manage LDAP & HIP Contracts
Process LDAP Enrollment
To allow for better coordination of our programs you'll see a few more changes with LDAP and HIP.
and will soon cover drug copays, coinsurances, & deductibles
(known as cost shares) for insured individuals.
medical (non-drug) cost shares for insured individuals.
Manage L-DAP & HIP Contracts
Process L-DAP & HIP Enrollment
Coordinated through HAART.
Managed through Ramsell
*If you need assistance paying for premiums, please double check that the insurance plan you sign up with will accept premium payments from HIP.
*For the purposes of this application, only state legal marriages are considered. Therefore, even if a couple has a federally recognized marriage or was married in another state, they are not considered married unless the state of Louisiana recognizes their marriage.
Clients must complete a 12 month recertification for HIP annually on their month of birth. This requires them to fill out an entire HIP application and check the
box on the HIP application.
Clients must also complete a 6 month verification on the month that falls 6 months after their birth month. This is a one page document that can be found by clicking the “6 month verification” link at haartinc.org
For assistance completing a HIP application ask for:
Brandy Davis (ext. 144)
For application status updates ask for:
Enroll Louisiana Inc. (www.enrolllouisianainc.com)
4664 Jamestown Ave, Suite 125
Baton Rouge, LA 70808