Delaware ’ s Health Insurance Marketplace: Update on Activity

1. Delaware’s Health Insurance Marketplace:Update on Activity Delaware Health Care Commission January 8, 2015 Secretary Rita Landgraf Department of Health and Social Services

2. Agenda • Medicaid update • Marketplace enrollment report • Enrollment stories • 2014 Taxes • Penalty • Health Care Costs • Outreach and Communications update • Key dates

3. Medicaid Newly-Eligible Enrollment Update From the start of the first open enrollment in October 2013 through December 31, 2014, 9,683 individuals have enrolled in Medicaid through the expansion. This is an increase of 3.9% over last month’s total. 23,980 Delawareans enrolled in health care coverage for plan year 2014 through expanded Medicaid and the Marketplace.

4. Marketplace Enrollment • On December 30, 2014, the U.S. Dept. of Health and Human Services released information on open enrollment for the 2015 plan year • Nationally, as of Dec. 15, more than 4 million people had enrolled or re-enrolled in health insurance coverage • Trends noted in the Dec. 30report for the 37 states using HealthCare.gov: • Interest is high • Two-thirds of those who applied have selected a plan • Activity increased near the Dec. 15th deadline

5. Delaware’s Marketplace Enrollment Of Delawareans selecting a QHP: • 83% were eligible for financial assistance • 56% are new consumers and 44% are active reenrollments** *State-level enrollment data on SADPs or on SHOP was not included in the HHS report • Reminder: Consumers who enroll in a Marketplace QHP are eligible to enroll in a Marketplace SADP and must do so by Feb. 15. • Small businesses can enroll in SHOP year-round **HHS’s numbers do not include “automatic reenrollments:” those who retain coverage without returning to the Marketplace and selecting a plan

6. Delaware’s Marketplace Enrollment Of Delawareans who have completed applications: 66% have selected a plan 17% have been determined eligible to enroll, but have not selected a plan 16% have been assessed as eligible for Medicaid 1% are pending

7. National Demographics Highlights of those who have selected a plan in the 37 states using HealthCare.gov from November 15 to December 15, 2014: • 24% are 18 to 34 years old • 30% are 55 to 64 years old • 68% have selected a Silver plan • 87% will receive financial assistance

8. In-Person Assister Activity • From November 1 through January 3, Marketplace Guides and Navigators have helped consumers complete 501 enrollments and 147 renewals • Guides and Navigators also made 428 referrals to Medicaid • Marketplace Guides and Navigators are available to assist consumers with applications and enrollments in locations across the state, 7 days a week. Visit www.ChooseHealthDE.com for the most up-to-date listing of times and locations

9. Future Sustainability • The formal Marketplace Guide program will end as of March 31, 2015 • Other assisters within the community have been working throughout the open enrollment period and will be an integral part of providing assistance to consumers in the future: • Certified Application Counselors, including FQHCs • Federal Navigators • Agents and Brokers • We continue to work with stakeholders both in state government as well as in the community to ensure there is adequate capacity to meet future needs

10. Stories from the Ground A Bear man, who had been uninsured for 4+ years and received assistance through CHAP, decided to apply. He was ecstatic to learn that he qualified for a monthly tax credit of $385, bringing his monthly premium to $227. He said his wife will be happy that he finally has coverage. With a tax credit, a newly enrolled couple from Blades will pay less than a dollar a month. A 35-year-old Harrington man without coverage chose a bronze plan. With a tax credit, he will pay $30 a month.

11. Stories from the Ground • A Dover couple starting a new carpentry business did not have health insurance. They used $167 of a tax credit toward the premium, reducing their joint silver plan to $562 a month. • With assistance from an MPG, a Middletown man re-enrolled in coverage for himself and his wife. Because his income decreased, he reported a life change and the income drop. Result: continued affordable coverage. • A Wilmington man who was renewing his enrollment completed his application, but wasn’t able to pick a plan or see his tax credit because the hub could not verify his identity. The man mailed identity papers to the Marketplace.

12. 2014 Taxes Taxpayers who enrolled in health coverage through the Marketplace in 2014 will receive Form 1095-A, Health Insurance Marketplace Statement Those with health coverage through another source such as a job, Medicare or Medicaid, will not use Form 1095-A, but will check a box on their income tax return confirming their coverage Other tools will be available on HealthCare.gov that will help individuals to determine if they qualify for an exemption (Form 8965) or to reconcile their Premium Tax Credit for 2014 (Form 8962) Visit www.irs.gov/aca or www.healthcare.gov/taxes for more information

13. Penalty Under the ACA, if individuals do not have minimum essential coverage or receive an exemption, they will be subject to an individual shared responsibility payment—a penalty. • In 2014, the penalty is $95 per uninsured adult ($47.50 per child) or 1% of household income, whichever is higher. This will be paid on an individual’s 2014 taxes (filed in 2015). • In 2015, the penalty is $325 per uninsured adult ($162.50 per child) or 2 percent of income, whichever is higher. This will be paid on an individual’s 2015 tax return (filed in 2016). Consumers can avoid this penalty by enrolling in coverage by February 15, 2015. Even if individuals pay the penalty, they still don’t have any health insurance coverage and they are responsible for 100% of the cost of their medical care. • Get an estimate of your penalty at www.ChooseHealthDE.com

14. Deductibles and Premiums • The rising cost of health care has a direct impact on premiums and deductibles. • The rise in deductibles continues to be a significant issue for consumers, business owners and providers. • It is difficult to compare historical deductibles to the deductibles in QHPs, because preventive services that are now 100% covered in QHPs are not subject to the deductible. This promotes preventive care and aims to reduce health care costs by finding and treating health issues early. • Consumers need to weigh each plan’s premium with its deductible to ensure they are selecting the right plan with the lowest out of pocket costs • A 2014 Kaiser Family Foundation study found that Delaware is in the area of the U.S. with the second-lowest average annual deductible for employer plans (https://kaiserfamilyfoundation.files.wordpress.com/2014/09/8625-employer-health-benefits-2014-annual-survey6.pdf)

15. Addressing Health Care Costs • The HCC approved new QHP standards which provide guidelines and the regulatory framework for insurance companies to develop “narrow network” plans with lower deductibles in 2016 • The Delaware Center for Health Innovation, through the State Innovation Model grant, will work to support the health care community to improve how care is paid for and delivered with the goal of reducing costs, increasing quality and increasing patient satisfaction

16. Outreach and Communications Update

17. Q4 2014 Traffic to ChooseHealthDE.com • Campaigns began running November 13, 2014 • There were 19,905 sessions on the site in the fourth quarter of 2014 • 6,257 (31%) of those were driven from paid media campaigns. • The percent of new sessions has increased since the campaign launched, up to 82% • 2,233 submitted information to the Penalty Calculator • 1,179 submitted information to the Assistance Finder

18. Total Traffic to ChooseHealthDE.com 4% 33% 41% • Campaigns began running November 13, 2014. • Paid media campaigns made up 33% of all traffic in November, and 41% of all traffic in December.

19. Clicks from ChooseHealthDE.com to HealthCare.gov ChooseHealthDE.com Healthcare.gov 2% • In Q4, ChooseHealthDE.com drove a total of 2,991 clicks to HealthCare.gov • 6% of those were from paid media campaigns. 5% 9%

20. Phase 2 of Mass Media Campaign • On January 5, the second phase of Open Enrollment marketing began • Emphasis on the February 15 deadline

21. Partner Meetings Across the State • The Marketplace team held a second round of community and stakeholder meetings in December • Attendees received an update on open enrollment and a demonstration of the penalty calculator and assistance finder tools on ChooseHealthDE.com • Community members provided feedback and engaged with Marketplace Guides and other assisters

22. National Youth Enrollment Day • January 29 marks National Youth Enrollment Day • Choose Health Delaware will host an enrollment event to provide an opportunity for the public to meet with Marketplace Guides and enroll in health coverage • Event details: January 29th, 10:00am-4:00pm Wilmington University, New Castle Campus Pratt Student Center

23. Key Dates • Medicaid enrollment is open all year. • Only those with qualifying life events, such as birth/adoption of a child, loss • of minimum essential coverage, aging out of parents’ insurance at age 26, • etc., may enroll in the Marketplace after February 15th.

24. Thank you!