Oregon: How to Update Your Information and Change or Renew Your Medical Coverage on Healthcare.gov

Transcription

1 Oregon: How to Update Your Information and Change or Renew Your Medical Coverage on Healthcare.gov Welcome Use this guide if you are updating your information and changing or renewing plans to the Trust- Approved Plan available for your area next year. The Oregon Homecare Worker Supplemental Trust and the Oregon Homecare Worker Benefit Trust provide premium assistance, out-of-pocket expense assistance, dental, vision, hearing, employee assistance program ( EAP ) benefits, and paid time off ( PTO ) benefits to eligible homecare and personal support workers. This unofficial guide provides step-by-step instructions for navigating and letting the Trust know your new medical plan information. As a Trust-eligible homecare worker, you may be eligible to receive assistance from the Supplemental Trust in paying for your medical premiums and certain out-of-pocket medical expenses. Any insurance that you sign up for through is not a group plan or an employersponsored plan; rather, it is individual insurance. If you move, stop doing homecare or personal support work or your hours decrease, your insurance will not be automatically canceled. However, these events may impact your eligibility to receive premium assistance from the Supplemental Trust and your eligibility to receive dental, vision, hearing, EAP, and PTO benefits under the Benefit Trust. You are responsible for ensuring your information on file with the Marketplace and with the Trusts is correct, your monthly premium payment is made to the insurance carrier on time, and you have updated the Trust with any new information about your medical coverage. If you have any questions refer to the Trust website at or call the Healthcare Enrollment Team at (Portland Metro Area) or toll free at Page 1 of 21

2 Welcome Back! The fastest way to update and change your Qualified Health Plan is to create a healthcare.gov account and update your information directly with the Marketplace on your own by following the steps in the first section of this guide. Please Note: This option is only available during open enrollment, which is November 1 through December 15 for medical coverage starting the following January 1. Updating and changing your health insurance can be completed without assistance. However, for those who would like to discuss or compare plan options, have multiple life changes, or would just prefer to work with someone directly, enrollment assistance is available by appointment with a Valley Insurance Professionals agent or with the Healthcare Enrollment Team. To review this process, please see the Creating a HealthCare.Gov Account guide on the Trusts website, which provides steps for receiving assistance from an agent or the Healthcare Enrollment Team even if you are not enrolling for the first time. Pre-Enrollment Steps Go to the Trust website at org. In the Benefits drop down menu, select Open Enrollment Materials for the plan year for which you want to enroll. Once you find the page for the current enrollment period, determine which medical coverage plan is the Trust-Approved plan for your county. You can find a county reference guide at You can choose any plan you d like for coverage, but to be eligible for Trust benefits, you must enroll in to a Trust-Approved Plan. When you find the Trust-Approved Plan for your area, go to to review the steps of the enrollment process. Next, fill out the annual pre-enrollment forms securely via DocuSign. For more details on how to use DocuSign, you can refer to the DocuSign resource guide at If you have updated your information with the Marketplace in the past two years, and are happy with your medical coverage and are auto-renewing onto a Trust-Approved Plan, you do not need to update your information with the Marketplace. Page 2 of 21

3 Steps to Update Your Information and Change Your Plan Changing plans while updating your medical insurance can be done online at However, unless you have a qualifying life event, this option is only available during open enrollment, which is November 1 through December 15 for coverage in To update, follow the steps below. The Health Insurance Marketplace strongly recommends you update your Marketplace application with your most recent income and household information so you get the right amount of financial assistance for You should do this as soon as possible so that you receive the correct premium bill information for your January premium. Go to and click on LOG IN TO RENEW/CHANGE PLANS. If you do not have a Marketplace account, find the guide Creating an Account on HealthCare.gov on the Trust website. Enter your Username and Password and click LOG IN. Please Note: your Username may be your address. Please note: Throughout this guide, we use Jane Doe as a fictional participant to illustrate how to complete different steps of the renewal process. Watch for these symbols in this guide: means Enter text here means Click here Page 3 of 21

4 Click on CONTINUE Note that the Marketplace has started your 2019 application based on the most current information they have on file for you. Click REVIEW MY APPLICATION. The first part of the application is the Privacy Policy. Read through the information to understand how the Marketplace uses, stores, and retrieves your personal information. If you understand and agree, check both boxes and click TAKE ME TO THE APPLICATION Page 4 of 21

5 Review the personal information (name, date of birth, social security number) and verify that it is correct. If you need to make any of the changes in the checklist (update a person s name or add a new person, remove a person, update income or other information), mark the box next to that item. Please note that information of a fictional participant is being used to illustrate the process. Review and fully complete the Contact Information section as this information could affect your plan options and/or tax credits. Check each section, and update as necessary. If you would like to see whether you qualify for Advanced Premium Tax Credits (APTCs), be sure to answer Yes to the last question in this section. Please note that to qualify for assistance from the Trust in the payment of premiums, you must elect to apply the full amount of any Federal premium tax credit to which you are entitled to the payment of the premium for your qualified health plan (for more information see page 13 of the Plan Booklet, which is available on the Trust Website). When the section is complete, click CONTINUE. Answer questions to determine your eligibility. Note that all questions are required; you will not be able to continue until you have answered all questions in this section. Page 5 of 21

6 Next you will need to complete a series of questions about your personal contact information, including: Name and date of birth Home address Home address verification/matching with the US Postal Service County Mailing address and phone number Preferred language Contact preferences After completing the personal information forms, you will be asked if you are receiving help completing your application. For tracking purposes with the insurance carriers, all Homecare Workers are listed under the same agent. So that you are able to access help from Valley Insurance Professionals in the future, please use the following information to complete this section: For Kaiser, PacificSource, Providence or MODA, select Agent or broker and fill in the following: First: Lisa Last: Schneider Organization Name: Valley Insurance Professionals NPN Number: Then click Save and continue Watch for these symbols in this guide: means Enter text here means Click here Page 6 of 21

7 Over the next several screens, you ll be asked for personal demographic information, including: Social Security Number Sex Ethnicity and race Whether you and/or others on your application have a physical or mental disability Whether you and/or others on your application were found ineligible for the Oregon Health Plan (OHP) or OHP s Children s Health Insurance Program (CHIP) Whether you and/or others on your application have an OHP or CHIP plan that has ended recently or will be ending soon Now you will be asked to review and verify or change the income and expense information that the Marketplace has recorded for you. a. If this information looks correct, click Yes, then Save and continue on the bottom of the page, or b. If you need to change your income or expense information, click the Edit link next to the income or expense source that you would like to change. See next page for important information about adding/ changing income and step-bystep instructions. Watch for these symbols in this guide: means Enter text here means Click here Page 7 of 21

8 The following information only applies if you are changing your income and/ or expenses information. If you are not changing this information, skip to next page. If you are adding income from homecare or personal support work to your application, you must include the following information: Select a type of income: Job (like salary, wages, commission, and tips) Employer name: Consumer client How often you get paid: Select how often you generally get paid Enter the amount you get paid in that time period. In the question that asks you to Enter the phone number where we can reach Consumer Client, enter This is the phone number for the Oregon Homecare Commission The next three screens will ask about coverage changes for you and/or others on your application. These include: Recent coverage changes (Mark the box next to the name of anyone on your application who will lose qualifying health coverage between the dates listed). Upcoming coverage changes Life changes You can also add additional income sources or expenses on this page. Relevant expenses are student loan interest, alimony payments, some IRA contributions, some educator expenses, and/or penalty on early withdrawal of savings. Important information about adding or changing your income source: For the purposes of completing your Marketplace application, your consumer client needs to be listed as the employer. Page 8 of 21

9 The next three screens will ask about coverage changes for you and/or others on your application. These include: Recent coverage changes (Mark the box next to the name of anyone on your application who will lose qualifying health coverage between the dates listed). Upcoming coverage changes Life changes Now, you will be asked to review your application in its entirety. Please take time to be sure you ve answered all questions correctly to the best of your knowledge. If any information is wrong, you will be able to change it in most cases by clicking the blue Edit link to the right of the information you wish to change. Page 9 of 21

10 Read the final statements and select whether you agree or disagree. Please note: In order to continue to receive Trust premium assistance you must agree to allow the Marketplace to review your information for up to five years. You must also agree to keep your information up to date. By signing a Statement of Understanding, you acknowledge that you understand this process. If any of the information on the application changes, it is your responsibility to let the Marketplace know. Once you have answered all the questions, click SAVE & CONTINUE. Make note of your application number (found on the bottom of the screen below the green button) on line 1 of the Plan Information Form on the last page of this guide. Read the statement. If you agree, click the box next to I agree to this statement, then type your full legal name in the box and click SUBMIT APPLICATION. Once you have reviewed and submitted your application you will be able to view your Eligibility Notice. Click VIEW ELIGIBILITY NOTICE (PDF). It is very important to review this notice and look for the section titled What should I do next? In order to resolve any data inconsistencies, the Marketplace will list any documents that the Marketplace needs you to send to them as well as the dates on which those documents are needed. Once you review your Eligibility Notice, click CONTINUE TO ENROLLMENT. Page 10 of 21

11 Now you can start the Enroll To-Do List by clicking on START next to Decide how much tax credit to use to use to lower your premium. Note that if you do not qualify for premium tax credits, your enrollment checklist will not include the option to decide how much tax credits to use to lower your premium, and your list will start with Report tobacco use. Skip to next page. There are three ways to use the tax credits. However, to qualify for premium payment assistance by the Trust, you must elect to apply the full amount of any Federal premium tax credit to which you are entitled, toward payment of the premium for your Exchange plan. You may visit the Homecare Worker Supplemental & Benefit Trusts website at for more information. In order to continue to receive premium assistance from the Supplemental Trust, click USE ALL $[xxx] EACH MONTH (the green button in the first blue box). In this case, our fictional participant (Jane Doe) has a $186 per month tax credit available to her. Your tax credit may be more or less depending on your financial situation. Make note of your premium tax credit amount on line 3 of the Plan Information Form on the last page of this guide. Page 11 of 21

12 Report tobacco use by clicking Start. On the next screen, indicate whether you have used tobacco products regularly in the last six months. Over the next several screens, you will have an opportunity to view different plans available on the Marketplace. You may choose any plan, but in order to be eligible for premium assistance through the Supplemental Trust you must select the Trust-Approved Plan for your area. A list of Trust-Approved Plans is available as an addendum at the end of this guide. If you know that you would like to re-enroll in a Trust-Approved Plan, you can click the SKIP or NEXT button at the bottom of the page. If you would like to shop for other plans on the Marketplace, follow the prompts on the screens. Page 12 of 21

13 Your current plan will show first as your Selected Plan. If you were enrolled in a Trust-Approved Plan in 2018, the plan you auto-enroll into (and the top choice on your screen) should also be a 2019 Trust-Approved Plan. To confirm that a plan is the Trust- Approved plan for your area, you can refer to the list of Trust-Approved Plans at the end of this guide. You can also visit the Trust website at and check the 2019 Marketplace Enrollment Materials page to find the Trust-Approved Plan for your area. To enroll in this plan, simply click Enroll. If you would like to review other Marketplace plans available in 2019, click the green Filter Plans button in the upper right corner of the screen. You may choose any plan, but in order to be eligible for premium assistance through the Supplemental Trust you must select the Trust-Approved Plan for your area. A list of Trust-Approved Plans is available as an addendum at the end of this guide. Our fictional participant, Jane Doe, is re-enrolling in her Trust-Approved Plan for Your Trust- Approved Plan is determined by the county in which you reside. In our example, Jane Doe lives in Multnomah County. To search for plans: Click the green Filter Plans button in the upper right corner of the previous screen. All Trust- Approved Plans will be found in the Silver category. Check the box to the left of Silver, and then click APPLY FILTERS. You can also go directly to the plan of your choice by entering its Plan ID Number in the Search by Plan ID field in the bottom left corner. You can find a reference with all Trust-Approved Plans and Plan IDs in the back of this guide. Once you have found the Trust-Approved plan for your area, click ENROLL. Page 13 of 21

14 Next, verify you have selected the correct plan, and make note of the monthly premium on Line 2 of the Plan Information Form at the back of this guide. Click Yes and Continue. At this point, you may have the option of choosing whether to add dental coverage to the plan you have chosen. Make your selection (Yes or No) and click Finish Plan Selection. Before saying yes to separate dental coverage, please note that if you are eligible for Supplemental Trust benefits you are also eligible to receive free dental insurance through the Homecare Worker Benefit Trust. You can call the Trust Administrative Office at , Option 3, Option 2 with questions about Dental coverage and eligibility. Congratulations Your Marketplace application is complete! But the enrollment process doesn t end here continue reading for some important information about activating your plan. Page 14 of 21

15 Submit Your Premium Information The Trust will need to know your monthly premium information for 2019 to update your benefits on your Benefit Convenience Card or send you a Benefit Convenience Card. You will want to check your monthly premium bill and payments to ensure that you are paying your premium payments in full, after the Advance Premium Tax Credit, on time every month. Please be sure to complete the following documents, available on the Oregon Homecare Worker Trust website, orhomecaretrust.org Benefit Convenience Card Affidavit please sign and submit securely via DocuSign You must submit the Benefit Convenience Card Affidavit annually to indicate that you understand the basic usage of the Benefit Convenience Card. You can learn more about the Benefit Convenience Card by reading the Frequently Asked Questions about the Card in your Plan Booklet. Enrollment Information Form please complete and submit online You must submit the Enrollment Information Form to the Trust Administrative Office after you enroll into your individual medical insurance, anytime your premium changes or anytime your medical coverage changes. The Trust Administrative Office needs this information so that they can start processing or update your benefits. Note: Once you submit this information and it is received by the Trust Administrative Office, it can take up to 20 business days to see that information reflected on your Benefit Convenience Card. Pay Your Premium to Activate Your Coverage You will get a bill from your insurance carrier once your information is processed. You will need to pay this bill to activate your insurance coverage. If you are enrolling for the first time, automatically reenrolled, or updating your Marketplace plan information, your premium amount should be different, so make sure you pay the new amount. If you do not pay your new premium in full, on time, by the due date, you will not activate or re-activate your coverage and could be without medical insurance for the entire year. If you are eligible for coverage under the Supplemental Trust, the Trust will reimburse you for the amount of your individual premium that is not covered by the maximum advance premium tax credit available to you. Included in this mailing is a reimbursement form and self-addressed envelope you can use to submit your reimbursement request. Please remember to include a copy of your bill with this request. Once the Trust Administrative Office processes your reimbursement request you will be set up to receive a Benefit Convenience Card ( Card ) that you can use to pay your future monthly premiums for as long as you are eligible for coverage under the Supplemental Trust. Send your premium reimbursement request to: Mail: Attention Homecare Workers Trust, PO Box 6, Mukilteo, WA Fax: Attention Homecare Workers Trust, If you already have a Card, your premium information will be updated with the information that you

16 submit to the Trust on the Enrollment Information Form and you can continue to use that Card to pay your monthly premiums for as long as you are eligible. Monitor Your Mail If you haven t already done so, please make sure that the Health Insurance Marketplace does not need any additional information from you. If they do, you need to submit that information to them so that your medical insurance, any Advance Premium Tax Credits, or any Cost Share Reductions you qualified for do not get cancelled. Get a Medical Card if You Enrolled in a New Plan If you enrolled into a new medical insurance carrier for the first time, once they receive your premium payment they will send you a medical ID card. Some carriers also offer the opportunity for you to print a medical ID card online. Check with your medical carrier. Set Up Automatic Payments Contact your insurance carrier to set up automatic payments from your Benefit Convenience Card to pay your monthly premium by the due date for as long as you are eligible for benefits under the Supplemental Trust. If your insurance carrier does not receive your monthly payments by the due date, it can cancel your insurance for non-payment and you will not be able to enroll into new medical insurance unless you qualify for a Special Enrollment Period or until the next Open Enrollment Period, which could mean going without medical coverage for an entire year. If you have set up automatic payments, and you are enrolled with the same insurance carrier, your automatic payments may continue; however, you may need to update the amount that is withdrawn based on your new premium amount. Make sure you monitor your premium payments. If you are enrolled into a different insurance carrier for 2019 you will need to set up automatic payments with your new insurance carrier. Monitor your account and call your carriers to make sure that your premium payments get paid by the due date so that your medical insurance does not get cancelled. Deductibles, Co-pays, Coinsurance, and Prescriptions You may also use your Benefit Convenience Card to pay for up to $6,000 of your covered out-ofpocket medical expenses incurred during the 2019 plan year. Learn more about the Card by referring to your Plan Booklet and the Benefit Convenience Card Frequently Asked Questions. When you receive services, your insurance carrier will provide you with an Explanation of Benefits (EOB) that shows what was paid to your provider and what you owe the provider. You can use your Card to pay for those medical and prescription drug copays, deductibles and co-insurance expenses relating to claims covered by your Trust-Approved medical plan, provided the claims were incurred while you were eligible for Trust benefits. You cannot use the Card for dental claims, vision claims, claims relating to family members or other individuals, claims for services not covered by your Trust- Approved medical plan or claims for services you accessed while you were not eligible for Trust benefits. Page 16 of 21

17 2019 Trust-Approved Plans (Oregon) Oregon County Baker Benton (Kaiser Service Area) Benton (Outside Kaiser Service Area) Clackamas (Kaiser Service Area) Clackamas (Outside Kaiser Service Area) Clatsop Columbia 2019 Trust-Approved Plan (Auto-Mapping Included) Providence: Providence Oregon Standard Silver - Choice Network, ID 56707OR PacificSource: PacificSource Oregon Standard Silver Plan LHN, ID 10091OR Providence: Providence Oregon Standard Silver - Choice Network, ID 56707OR Moda: Moda Health Oregon Standard Silver (Beacon), ID 39424OR or Coos* I 56707OR or the Moda: Moda Health Beacon Silver 3000, ID 39424OR Crook PacificSource: PacificSource Oregon Standard Silver Plan SCN, ID 10091OR Moda: Moda Health Oregon Standard Silver (Beacon), ID 39424OR or Curry* or the Moda: Moda Health Beacon Silver 3000, ID 39424OR Page 17 of 21

18 Deschutes Douglas Gilliam Grant Harney Hood River (Kaiser Service Area) PacificSource: PacificSource Oregon Standard Silver Plan SCN, ID 10091OR Providence: Providence Oregon Standard Silver - Choice Network, ID 56707OR Moda: Moda Health Oregon Standard Silver (Beacon), ID 39424OR or Hood River (Outside Kaiser Service Area)** Providence: Providence Oregon Standard Silver - Choice Network, ID 56707OR or the Moda: Moda Health Beacon Silver 3000, ID 39424OR Moda: Moda Health Oregon Standard Silver (Beacon), ID 39424OR or Jackson** Providence: Providence Oregon Standard Silver - Choice Network, ID 56707OR or the Moda: Moda Health Beacon Silver 3000, ID 39424OR Jefferson PacificSource: PacificSource Oregon Standard Silver Plan SCN, ID 10091OR Moda: Moda Health Oregon Standard Silver (Beacon), ID 39424OR or Josephine* I 56707OR or the Moda: Moda Health Beacon Silver 3000, ID 39424OR Providence: Providence Oregon Standard Silver - Signature Page Network 18 of 21

19 Klamath Lake Lane (Kaiser Service Area)*** Lane (Outside Kaiser Service Area) Lincoln Linn (Kaiser Service Area) Linn (Outside Kaiser Service Area) Malheur Marion (Kaiser Service Area) Marion (Outside Kaiser Service Area) Morrow Multnomah Polk Sherman Providence: Providence Oregon Standard Silver - Choice Network, ID 56707OR Providence: Providence Oregon Standard Silver - Choice Network, ID 56707OR Providence: Providence Oregon Standard Silver - Choice Network, ID 56707OR Providence: Providence Oregon Standard Silver - Choice Network, ID 56707OR Page 19 of 21

20 Moda: Moda Health Oregon Standard Silver (Beacon), ID 39424OR or Tillamook* or the Moda: Moda Health Beacon Silver 3000, ID 39424OR Umatilla Union Wallowa Moda: Moda Health Oregon Standard Silver (Beacon), ID 39424OR or Wasco* or the Moda: Moda Health Beacon Silver 3000, ID 39424OR Washington Wheeler Yamhill * If you have the option to enroll in the Moda: Moda Health Oregon Standard Silver (Beacon), ID 39424OR , you may also choose the Providence: Providence Oregon Standard Silver - Signature Network, or the Moda: Moda Health Beacon Silver 3000, ID 39424OR ** If you have the option to enroll in the Moda: Moda Health Oregon Standard Silver (Beacon), ID 39424OR , you may also choose the Providence: Providence Oregon Standard Silver - Choice Network, ID 56707OR or the Moda: Moda Health Beacon Silver 3000, ID 39424OR *** For 2018 Providence enrolled participants that now reside inside the Lane County Kaiser Service Area: either Providence: Providence Oregon Standard Silver - Choice Network, ID 56707OR or Kaiser Permanente $2,500 Deductible Silver 2500/30 plan, Plan. Page 20 of 21

21 My 2019 plan information 1. Application ID: 2. Base (or Gross) Premium Amount: 3. Advance Premium Tax Credit (APTC) Amount: 4. Net Premium after APTC Amount: 5. Effective Date of the Plan: 6. Date Any Verification Documents are Due: Page 21 of 21