michigan guide to health insurance

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Michigan health insurance exchange

123K enrolled in MI as of Dec. 15

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Michigan residents apparently had pent-up demand for health insurance. Enrollment in both marketplace plans and Healthy Michigan, the state’s revamped Medicaid program, “blew through” projections for 2014 and beyond.

And, 2015 signups are proceeding at a good pace. More than 123,000 Michigan residents have selected a health plan during the second open enrollment period on HealthCare.gov. Fifty-three percent of those signing up were new to the marketplace for 2015. Eighty-nine percent of Michigan residents who selected a health plan qualified for financial assistance, compared to 87 percent in all states that use HealthCare.gov.

In addition to those who signed up for private coverage (qualified health plans, or QHPs), 36,015 people qualified for Medicaid or the Children’s Health Insurance Program (CHIP).

Data is for the period Nov. 15, 2014 through Dec. 15, 2014; it does not include individuals whose policies were auto-renewed.

Open enrollment to buy health insurance through the marketplace runs through Feb. 15.

Update your info to get correct subsidy

If you qualified for a subsidy for 2014 coverage, make sure you update your income and household information — even if were automatically re-enrolled. The amount of your subsidy will vary from year to year based on your income and other factors. To make sure you’re getting the right amount in 2015, visit HealthCare.gov and record what’s changed for you over the past year.

While you’re on the site, take time to check out your 2015 health plan options, too. In Michigan, you have more plans and insurers to choose from than in 2014. Odds are good you can save money by switching plans. You can make changes until Feb. 15, even if your 2014 was already renewed.

Insurers and rates on 2015 exchange

Sixteen insurers are selling policies through the Michigan exchange for 2015 coverage, up from 12 in 2014 according to HHS. All insurers that participated in 2014 stayed in the marketplace for 2015, and four carriers are new.

Data gathered by the Commonwealth Fund shows 2015 premiums decreased 1 percent on average for marketplace plans.

The Michigan Department of Insurance and Financial Services website includes a premium estimator and a list of premiums by insurance carrier, metal level, age, and smoking status.

Transitional plans

Although Michigan is allowing insurers to extend transitional, or “grandmothered,” health plans for several more years, some insurers opted to discontinue their offerings in 2015. These are plans that don’t meet ACA requirements, but have been allowed to stay in effect awhile longer.

If you received a notice that your plan is being cancelled, you have several options. You can shop for new coverage directly through your current carrier, through an agent or broker, or through the marketplace at HealthCare.gov. You can also see if you qualify for a hardship exemption, or skip coverage and run the risk of owing a penalty.

Penalties increase for 2015

The ACA’s individual mandate requires most people to have health insurance or pay a penalty; however, there are quite a few exemptions.

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

  • 2% of annual household income. Using this method, the maximum penalty is the national average premium for a bronze plan or about $3,000 according to Exhibit 1 in this Commonwealth Fund analysis.
  • $325 per adult or $162.50 per child under 18. Using this method, the maximum amount a family will pay is $975.

Use the healthinsurance.org calculator to see if you may have to pay a penalty.

2014 enrollment recap

More than 272,500 Michigan residents signed up for qualified health plans. Eighty-seven percent qualified for financial assistance, compared to 85 percent nationally. An HHS report shows the average monthly premium, after tax credits, for Michigan consumers as $97. Thirty-nine percent of enrollees pay $50 or less per month after subsidies.

Thirteen percent of Michigan residents selected a bronze plan (20 percent nationally), 75 percent selected a silver plan (65 percent nationally), 9 percent selected a gold plan (9 percent nationally), 2 percent selected a platinum plan (5 percent nationally) and 2 percent selected a catastrophic plan (2 percent nationally). Twenty-eight percent of Michigan enrollees were between the ages of 18 and 34.

Background on Michigan’s exchange efforts

Gov. Rick Snyder, a Republican, supported a state-run exchange for Michigan. However, he did not have the support of enough fellow Republicans to move ahead.

The Michigan attorney general joined 25 other states in challenging the Affordable Care Act. The Senate passed a bill to authorize a state-run exchange, but bill was voted down by the House’s Health Policy committee and didn’t get a floor vote.

Eventually, the state moved ahead with a state-federal partnership. Michigan is responsible for plan management, but left all other functions to the federal government.

Michigan health insurance exchange links

HealthCare.gov
800-318-2596

Enroll Michigan
Statewide network of non-profit agencies providing free enrollment support services to health insurance consumers

Michigan Health Insurance Consumer Assistance Program (HICAP)
877-999-6442