September 22, 2014
If you signed up for health insurance this year through healthcare.gov, there are some important reminders for Marketplace users as we approach the end of 2014 and the beginning of Open Enrollment for 2015.
Income Verification Requests from the Marketplace
The Marketplace will likely be reaching out to you in the upcoming weeks if the income you reported in your application differs significantly from your income report on past tax returns. In many cases, this is because of a change in employment or some other completely verifiable reason. Unfortunately, the website did not have the proper functionality to confirm this information at the time of application so they are now going back to verify incomes to ensure that subsidies are being paid out accurately.
If you get any request via email or mail from the Marketplace asking for documents to verify your income, RESPOND ACCORDINGLY. If you do not respond to these requests, you are at risk of losing your federal subsidy or being paid the incorrect subsidy. Read more on income verification requests here.
Preparation for Open Enrollment for 2015
Open Enrollment for 2015 begins on November 15th, 2014 and runs through February 15th, 2015. I recommend that you check your username and password now at healthcare.gov. Please follow the instructions to retrieve you username and password if needed.
You will be AUTOMATICALLY RENEWED in your current plan for 2015 (with a benefit year of 1/1/15 – 12/31/15). Read more about anto-renewal here.
Starting on November 15th, you will want to log in to your healthcare.gov account and confirm that your income and household information is accurate for 2015. You should be able to see your new recalculated premium for 2015 as well. At this time, you can also shop or look for other plans.
The termination of the contract between UPMC and Highmark may be an issue for you this year. United Healthcare is going to be a new carrier on the Exchange. Highmark, UPMC and HealthAmerica will continue to offer plans through healthcare.gov. According to the contract:
- You will not be able to see most UPMC-owned physicians or hospitals if you are on a Highmark plan in 2015 (Children’s Hospital and Western Psych are the main exceptions)
- You will not be able to see any Allegheny Health Network hospitals with a UPMC plan (West Penn, AGH, Forbes are the main ones). Both Allegheny Health Network and UPMC facilities are in-network with HealthAmerica and United Healthcare. Details of the Highmark UPMC contract end and its implications for members can be found here.
Unfortunately, the rates and details for the 2015 will not be available until November 15th. That is why it is very important to make sure your healthcare.gov account is active with a known username and password now – the site will likely be VERY busy come November 15th.
Further updates and important reminders for Marketplace users will be coming!