2015 open enrollment on the health insurance marketplace is now underway, running through Feb. 15, 2015.
Officials are encouraging everyone who had coverage in 2014 to take a look at their options for 2015. Given that subsidy levels, personal circumstances, and health plans offerings can all change, a new plan may be a better fit going into 2015.
Even if you want to keep your current health plan for 2015, be sure to verify your income and document any important life changes (like a new job or a baby) by Dec. 15 on HealthCare.gov. This information is used to determine you qualify for a subsidy and, if so, how much.
It also makes sense to look at the insurers and health plans available for 2015. Four new insurers and many more plan options are available through the Illinois marketplace in 2015. A new plan may make better financial sense for you.
No action on state-run exchange
Illinois runs its marketplace, Get Covered Illinois, as a partnership with the federal government. State residents use the federal marketplace, HealthCare.gov, to enroll.
Outgoing Gov. Pat Quinn has consistently supported a state-run exchange. A bill authorizing a state-run exchange passed the Illinois Senate in 2013, and there was hope the House might give its support during the 2014 fall veto session. However, sponsors did not have enough support to bring the bill to a vote.
Rep. Robyn Gabel had hoped the issue would gain traction, given that the U.S. Supreme Court is considering whether premium subsidies can be lawfully provided in states that don’t run their own health insurance exchange. By transitioning to a state-run exchange, Illinois would have secured ongoing subsidies for its residents regardless of how the Court rules.
Now, a state-run exchange is unlikely for the foreseeable future. Illinois had filed for federal grant money to set up a state-run exchange; however, grants cannot be awarded after 2014. Without grant money, the state would be challenged to get the exchange up and running.
Another financial challenge to a state-run exchange is ongoing operating expenses. The 2013 Senate bill authorizing a state-run exchange called for insurers to pay a tax on premiums to fund operating expenses. Opponents of that funding option say the cost would just get passed on to consumers.
2015 rates up slightly on Get Covered Illinois
The Illinois Depart of Insurance summarized 2015 premium increases by metal level:
- Lowest gold plan average: 3.7 percent increase
- Lowest silver plan average: 2.6% increase
- Lowest bronze plan average: 11% increase
More than half of 2014 enrollees in Illinois selected a silver plan.
2015 participating insurers
More health plans are competing for business on the Illinois exchange for the 2015 plan year. The Illinois Department of Insurance announced that ten insurers are selling 410 health plans, including 17 options that are available statewide. For the 2014 plan year, six insurers offered 165 policies in Illinois.
Three new companies are participating in the Illinois marketplace for 2015: Time Insurance Company (Assurant Health), United Healthcare, and IlliniCare Health. IlliniCare Health is a partnership of Centene and several Chicago hospitals. Centene is a large player in the managed Medicaid market, and it entered the individual insurance market through the ACA marketplaces in several states in 2014.
Small business exchange
Illinois is one of five states where small businesses (those with between 2 and 50 employees) had early access to the federal Small Business Health Options Program (SHOP) online portal. Online enrollment functionality had been delayed so technical staff could work on fixing the marketplace used by individuals. Without the online function available, small businesses had been limited to working with a broker or by submitting a paper application to sign up for SHOP coverage.
Users in the early launch states experienced some problems with the SHOP according to The New York Times. Issues included some health plans not being displayed and glitches when using Firefox or Internet Explorer web browsers to access the site.
As of Nov. 15, the online SHOP was available in all states that use HealthCare.gov.
Nationally, SHOP enrollment has been limited according to a GAO report. As of June 2014, only about 76,000 people had enrolled through state-run SHOP exchanges; federal SHOP data was not available for the GAO report.
Illinois is delaying the launch of “employee choice” on SHOP exchange. The option allows employees of small businesses that use the SHOP to select from a range of plans rather than being limited to a single plan selected by their employer. The federal government let states that use the federal marketplace choose if they want to implement employee choice for 2015. Illinois is one of 18 states that is delaying implementation of employee choice.
A recap of 2014 enrollment
About 217,500 Illinois residents enrolled in qualified health plans (QHPs) during 2014 open enrollment and 468,000 have signed up for Medicaid as of Sept. 30. Get Covered Illinois announced that the state exceeded the initial enrollment target set by the federal government by 52 percent.
Of those Illinois residents who selected a QHP, 77 percent qualified for financial assistance, compared to 85 percent nationally. An HHS report showed the average monthly premium, after tax credits, for Illinois consumers was $105. Twenty-five percent of enrollees pay $50 or less per month after subsidies.
Twenty-nine percent of Illinois residents selected a bronze plan (20 percent nationally), 56 percent selected a silver plan (65 percent nationally), 15 percent selected a gold plan (9 percent nationally), 1 percent selected a platinum plan (5 percent nationally) and 0 percent selected a catastrophic plan (2 percent nationally). Thirty-one percent of Illinois enrollees were between the ages of 18 and 34.
History of the Illinois exchange
Gov. Pat Quinn’s administration announced in July 2012 that the Illinois marketplace would operate as a state-federal partnership. Quinn had hoped to leverage the partnership model as an interim step toward a state-run marketplace for the 2015 coverage year. However, a state exchange bill passed in the Senate in 2013 didn’t get a vote in the House. As noted above, there was some hope that exchange legislation will be considered during the fall 2014 session. However, the House did not take up the issue. Advocates fear it may be 2018 or later before the state takes over sole control of the exchange.
More than 685,000 Illinois residents enrolled in private insurance or Medicaid since October 2013, and the state’s uninsured rate in Illinois dropped more than 3 points according to a Gallup survey.
The drop in the uninsured rate is definitely good news. However, about 12 percent of state’s population remains uninsured, and officials know they need to make an even bigger effort to reach them for 2015. Officials awarded nearly $26 million to 37 organizations, with plans to target last year’s hard-to-reach groups: Latinos, African Americans, and millennials.
Illinois health insurance exchange resources
Get Covered Illinois
Illinois Health Matters
Information resource on health care reform
Health Care Assistance
Office of the Attorney General
877-305-5145 (toll-free nationwide) TTY: 312-964-3013
Serves residents enrolled in private health insurance
Office Consumer Health Insurance and the Ombudsman for the Uninsured
Illinois Department of Insurance
877-527-9431 (toll-free nationwide)
Serves residents who are uninsured as well as residents who have health insurance problems or questions.