Enrollment for health insurance through Affordable Care Act begins

10/01/2013 1:24 AM

10/01/2013 1:30 AM

About 108,000 residents of Stanislaus, San Joaquin, Merced, Mariposa and Tulare counties are believed to be eligible for subsidized coverage under the federal health law signed by President Barack Obama in 2010, which gives people the choice of being insured or paying a tax penalty next year.

Covered California approved four health plans for that region, offered by Anthem Blue Cross, Kaiser Permanente, Blue Shield and Health Net at premiums between $223 and $508 a month for a 40-year-old single adult, depending on level of coverage.

Uninsured single adults earning between $15,860 and $45,960 are eligible for tax credits to lower their premiums; the same goes for a family of four with annual income between $32,500 and $94,200.

Covered California said it has call centers running in Merced, the Sacramento area and Contra Costa County to assist the uninsured or people with coverage that doesn’t meet the new federal standard. People also can enroll online at www.coveredca.com and meet face-to-face with certified insurance brokers to sign up for plans.

The regional call center in Merced begins taking health care enrollment calls today from residents of Merced and eight other counties under the federal Affordable Care Act.

The $5.6 million call center is part of California’s compliance with the federal health care overhaul, which includes expanding Medi-Cal. The center’s 42-member staff will screen callers for Medi-Cal benefits and enroll them in other insurance plans as necessary.

They’ll handle calls from Mariposa, Madera, Inyo, Mono, Alpine, Amador, Calaveras and Tuolumne counties.

The call center added 42 new full-time jobs to the county, paying $40,000 to $43,000 a year with health benefits and retirement plans, according to Michelle Roe, Human Services Agency deputy director.

The call center employees work out of the Human Services Agency’s site on 16th Street.

Officials don't anticipate a flood of phone calls today because most residents are still figuring out what they need to do under the new law. Marketing for Covered California has barely started.

However, there will likely be an increase in call volume as the public learns more about the federal health care plan. An uptick in calls is also expected during tax season when people do their taxes and realize the mandate is in effect.

Experts say an increase of calls could come just before Dec. 15, the deadline for buying a policy for benefits beginning on Jan. 1, 2014. A final rush might come around March 31, the last day to buy 2014 coverage and avoid a penalty.

Enrollment was set to begin despite Republican threats of a federal government shutdown if Democrats in Congress do not agree to defund the Affordable Care Act. Covered California said it would not delay enrollment because of the clamor in Washington.

Kaiser Permanente nurses represented by the California Nurses Association held informational pickets in Modesto, Oakland and Sacramento on the eve of the enrollment kickoff, charging that Kaiser has made it harder for patients to receive hospital care when needed. Claiming they’ve reported 2,500 cases of unsafe care to Kaiser, the nurses suggested that consumers be wary of insurers that limit access to hospital care.

Kaiser responded that the union is upset about a labor dispute with the Oakland-based health provider. “This is just more of the same from the California Nurses Association, who continue to distort facts and make exaggerated and misleading claims to advance their agenda,” a Kaiser statement read.

On the day before enrollment, consumers still were unable to see lists of hospitals, doctors and pharmacies connected with the four health plans in the region. However, provider directories, showing which health care providers accept the insurance, reportedly will be available from the insurers starting today.

Insurance brokers expect that many valley residents, especially those with diabetes or high blood pressure, or those paying for expensive COBRA benefits, will jump at the chance of getting coverage. People will be on their honor for stating income when applying for tax credits to lower premiums, but they are being warned be honest because the Internal Revenue Service will be closely watching tax returns filed by April 2015 for 2014.

Understating income could result in having to repay all or a portion of the tax credit. People who start earning more at midyear, because of a promotion or job change, are advised to report that to Covered California or their brokers so their premiums are adjusted.

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