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Kentucky health insurance exchange / marketplace

KY extends enrollment, announces SEP

Kentucky is granting an extension to anyone who made a “good faith” effort to enroll prior to Feb. 15, but was unable to finish due to trouble with the website or getting through to the call center. Representatives will work with people to complete their applications by Feb. 28. To get help, call 1-855-4kynect and ask to be transferred to the Kentucky Health Benefit Exchange (KHBE) Tier II staff.

Kentucky is also granting a special enrollment period (SEP) for people who are just realizing they owe a tax penalty for not having insurance. Kentucky’s SEP runs March 2 through April 30.

The individual mandate, which requires most people to have health insurance, went into effect Jan. 1, 2014. However, many people aren’t aware of the mandate and only learn of it when they file their 2014 taxes. While consumers can’t do anything about the 2014 penalty at this point, a special open enrollment period will enable them avoid a penalty when they pay 2015 taxes.

As of Feb. 19, nearly 76,000 Kentuckians had re-enrolled in qualified health plans (QHPs) and 27,070 people had newly enrolled in QHPs. Additionally, nearly 56,000 people have qualified for Medicaid.

Enhancement for 2015

Even though Kentucky’s state-run marketplace was already one of the nation’s most successful exchanges in 2014, officials worked hard to make improvements and updates for 2015 open enrollment.

Kynect met with brokers, insurance carriers, and Kynectors (navigators) to get feedback and learn what areas need improvement. Enhancements include:

  • The call center increased the number of customer service representatives from 185 at the start of the first open enrollment period to 400 for the start of the 2015 open enrollment period. The call center also expanded operating hours and underwent a systems upgrade to reduce wait times and enable more efficient operations.
  • More agents, brokers, and Kynectors are participating in the 2015 open enrollment.
  • Kynect debuted a mobile app to enhance outreach and customer service, especially for the under-35, “young invincible” population. The app allows users to check plan options and see rates, and then complete their application on the Kynect website. As of Feb. 19, more than 8,500 people had downloaded the app.
  • Kynect launched a full-service enrollment center at the Fayette Mall in Lexington. Through Feb. 19, nearly 7,600 people visited the center and nearly 6,000 people applied for new coverage.

2015 options on Kynect

Five insurers are participating in Kentucky’s individual marketplace during 2015 open enrollment: Anthem Blue Cross and Blue Shield, CareSource, Humana, Kentucky Health Cooperative, and Wellcare of Kentucky. WellCare and CareSource currently offer Medicaid managed care plans in Kentucky, but have not previously participated in the private individual market.

In addition, two dental carriers, Dentegra and Delta Dental of Kentucky, are also offering plans through Kynect for 2015.

Penalties will rise

Those who are uninsured three or more months of the year may have to pay a penalty, and the penalties are increasing for 2015.

Those who don’t qualify for an exemption will have to pay the greater of:

  • 2% of annual household income. The maximum penalty under this calculation method is the national average premium for a bronze plan, which is about $3,100 according to .
  • $325 per adult or $162.50 per child under 18. The maximum penalty per family using this method is $975.

Use the healthinsurance.org penalty calculator to see how much you may owe.

Impressive coverage gains in 2014

Kentucky realized a 10.6 point decline in its uninsured rate following the launch of its health insurance marketplace and expansion of its Medicaid program. The percentage of people without health insurance dropped from 20.4 percent in 2013 to 9.8 percent in 2014, according to the Gallup-Healthways Well-Being Index. Only Arkansas had a larger drop.

Kynect officials said about 75 percent of those who signed up for coverage in 2014 did not previously have insurance. To help people who have little experience with the health care system or health insurance, the exchange has worked to create a consumer guide called “How to Kynect” and is providing it to new enrollees in order to help them learn how to select a primary care doctor, when to seek health care, when to visit the ER, how to use the pharmacy benefits on their plan, and understand insurance terminology.

History of Kentucky’s exchange

Kynect is considered one of the nation’s best marketplaces. More than 521,000 people obtained health insurance coverage through Kynect in 2014 — either private health insurance or Medicaid.

One sign of Kynect’s success is widespread awareness: a poll from late 2014 shows that nearly 80 percent of Kentucky residents have heard of the exchange and nearly 52 percent of Kentuckians between the ages of 30 and 64 said they knew “a lot” about it.

Another sign is the Beshear administration’s inclusion of Knyect in its list of top accomplishments of 2014. The state’s uninsured rate dropped nearly 8 points, and the newly insured are taking advantage of their coverage. The state reported 26,000 more people will have cholesterol screenings, 7,000 more women will have mammograms, 10,000 more women will have pap smears, and 14,000 more people with depression will be treated.

Kynect was one of the few marketplaces established through an executive order. Beshear’s order to establish the exchange in July 2012 followed months of seeming inaction on the exchange by the executive and legislative branches in the state. Kynect is part of the state’s Cabinet for Health and Family Services, and it is overseen by 19-member board appointed by Beshear.

Gov. Steve Beshear went against public sentiment in deciding the state would run its own marketplace. In an article in The New York Times, Beshear urged state residents to set aside politics and use the marketplace to get insured. “You don’t have to like the president; you don’t have to like me. Because this isn’t about him, and it’s not about me. It’s about you, your family and your children.”

Kentucky spent about $11 million on outreach and marketing for 2014 open enrollment, and it trained 5,000 people to support enrollment — including state employees, insurance agents, volunteers and representative of various community groups and social service organizations. These outreach efforts drove Kentucky’s enrollment totals.

While the federal marketplace, HealthCare.gov, and multiple state-run marketplaces had significant technical problems in 2014, Kynect ran well from the start. Experts say those in charge of implementing Kynect made good choices. They kept the design simple and worked with well-qualified and experienced vendors.

Kentucky health insurance exchange links

Kynect –  Kentucky’s Healthcare Connection
855-4kynect (855-459-6328)
Consumer site for Kentucky’s marketplace

Kentucky Health Benefit Exchange
Administrative site for Kentucky’s marketplace

A Healthier Kentucky

Kentucky Health Insurance Advocate, Kentucky Department of Insurance
Assists people insured by private health plans, Medicaid, or other plans in resolving problems pertaining to their health coverage; assists uninsured residents with access to care.
(877) 587-7222 /DOI.CAPOmbudsman@ky.gov