Recently lost health insurance from your job? Know your options.

Recently lost health insurance

from your job? Know your options.

Niki Conte

Associate Director of Public Outreach and Education

Today’s presentation topics:

•

General information about the state’s Health Connector and the

types of coverage available through MAhealthconnector.org

•

Rules around choosing Health Connector plans as an alternative to

COBRA and the new Special Enrollment Period due to COVID-19

•

Tips when applying for coverage, including choosing a plan and

enrolling

•

How to get free help with this process

What is the Health Connector?

• Those who don’t get health

insurance through their job or

other sources

The Massachusetts Health Connector is the state’s health insurance

Marketplace, offering individuals, families and small employers with

access to affordable coverage.

• Many people who apply, qualify

or help paying for their coverage

• Dental insurance is also available

or purchase

Health Connector Plan Options

All the plans sold through the Health Connector meet state and

federals standards for coverage

Qualified Health and

Dental Plans

Choose from a variety of

plans in your area from

the leading carriers in

Massachusetts

Health Plans with

Advance Tax Credits

Those with incomes within

a certain range can qualify

for tax credits to reduce

their cost of monthly

premiums

ConnectorCare Plans

Others within lower income

ranges and other eligibility

requirements may qualify

for low or no-cost health

insurance coverage

Catastrophic Plans

Available to those under

30 or with a hardship

exemption

Dental Plans

For individuals, families

and small employers

including; pediatric-only

and low and higher

deductible plans

Health Connector as an

alternative to COBRA

Health Connector as an alternative to COBRA

When leaving a job, COBRA may be offered to continue health

insurance benefits. Before making a final decision, review your

options through the Health Connector.

• Losing your employer coverage is considered a qualifying life event, which gives

you a special enrollment period for enrolling through the Health Connector

• Be sure to apply and compare your options through the Health Connector within

60 days of losing your employer coverage

• If you are a Massachusetts resident, you may apply for and enroll in coverage

through Mahealthconnector.org and indicate the date that your employer will no

longer pay for health insurance benefits

•

You’ll need to apply, enroll, and pay your first premium by the 23rd of the month

before your coverage can start

Special Enrollment Periods due to

COVID-19

COVID-19 Special Enrollment Period (SEP)

Given the COVID-19 emergency, the Health Connector has

created a Special Enrollment Period – now available through

July 23rd.

• To help ensure everyone who wants access to covered coronavirus services

has it, the Massachusetts Health Connector created and extended this

Special Enrollment Period

• This gives uninsured residents an opportunity to apply and get into health

nsurance coverage

• The new deadline to apply and enroll in coverage is July 23

• The Division of Insurance has extended a similar special enrollment period

which may be helpful for anyone not eligible to shop through the Health

Connector

Getting Coverage through the

Health Connector

Who qualifies for help paying for health insurance?

You may qualify if you:

• Shop through the Massachusetts Health Connector

• Live in Massachusetts

• Are a U.S. citizen, national, or are otherwise lawfully present in the U.S.

• Have income that is 400% of the Federal Poverty Level (FPL) or lower

You won’t be able to qualify if you:

• Get coverage through Medicare, MassHealth (Medicaid), or other public

health insurance programs, are in jail at this time or are offered affordable,

comprehensive health insurance from an employer

What are the income guidelines to get help from the

Health Connector?

Current Federal Poverty Level (FPL) guidelines are used to determine what

type of help is available.

Household Size 400% FPL

1 $49,960

2 $67,640

3 $85,320

4 $103,000

For each additional person add $17,680

The income limit for ConnectorCare plans is set at 300% of FPL -

$37,470 for a household of one and $77,250 for a household of four.

Applying for Coverage

What do I need to complete the application?

Here’s a checklist of things to gather:

• Social Security numbers for everyone applying (if they have one)

• Immigration documents for all non-U.S. citizens who are applying (if they have

one). Find more information about immigration documents here:

https://www.mahealthconnector.org/immigration-document-types

• Recent Pay Information

• Copies of your last two pay stubs

• If you are collecting unemployment, your unemployment amount (this can

be found on your award letter)

• A copy of your federal tax return from last year

• If you didn’t file taxes last year, or your income has changed since last year,

have information about your current income ready

Application for Individuals and Families

Begin your application at MAhealthconnector.org

There is a single application to find out if you qualify for help paying for

coverage. Some may be eligible for MassHealth while others may find that

Health Connector plans are a more affordable option than COBRA.

Application for Individuals and Families

How do I enter my income if I’m unemployed?

When you complete an application you’ll be asked about your current

income as well as your estimated income for the year.

• If you are applying or updating your income, you should enter

your

current income (as it is right now) without the $600 in

additional UI income, then update your expected yearly income

based on what you think you’ll make over the course of the

year

• When entering your yearly income, consider how much has

been earned so far this year, add any unemployment, including

the extra $600 per week, and include what might be earned if

and when you return to work later this year

• If your income changes later, update your income information

again so it is as correct as possible

Keeping your income and application up to date

• If you receive an Advance Premium Tax Credit (APTC), you can always

adjust the amount you take by using the slide on the Eligibility Results

page of your application

• Please keep updating your income as your employment situation

changes. Keeping your income information as accurate as possible

will help to make sure you:

• Get the right amount of help paying for health insurance

• Lower your risk of owing money to the IRS when you file taxes for 2020

Choosing a Plan and Enrolling

How do l choose the right plan?

Once you know what you qualify for, your next step is to shop for a plan

• The Health Connector has resources that can help you decide:

https://www.mahealthconnector.org/help-center/resource-download-

center

• Within the application, you can also enter your provider and

medication preferences, then see pricing and compare plan

designs from leading carriers in Massachusetts

ConnectorCare Plan Premiums and Benefits

ConnectorCare plans are affordable health insurance plans offered

through the Massachusetts Health Connector.

• They have low monthly premiums, low out-of-pockets costs, with no

deductibles. Remember they are subsidized by federal premium tax

credits + state subsidies

• Available to those who meet eligibility requirements, including income

below 300% of FPL

• Depending on the plan type you qualify for, you could choose a plan

for as low as $0 – up to $130 per month

Getting Help

Where can I get help enrolling in health

insurance coverage?

Free enrollment assistance is available through the Health Connector

Customer Service and across Massachusetts through Assisters (Navigators

and Certified Application Counselors (CACs)

• Customer Service:

1-877-MA-ENROLL (1-877-623-6765), or TTY 1-877-623-7773 for people who are

deaf, hard of hearing, or speech disabled. For information about hours and days of

operation, location and phone number visit:

https://www.mahealthconnector.org/about/contact

• Assisters:

Trained and certified assisters can help you from application through enrollment

into health insurance plans. They can answer questions about eligibility, the

application, payments, plan details, and health care reform rules and requirements.

It is recommended that you call ahead to schedule an appointment for help.

To find an Assister near you visit

https://www.mahealthconnector.org/here-to-help

Key Takeaways

Reminders and finer details about this shopping and enrollment

process:

• Applications for coverage can be submitted online or over the phone

 Some people will get an automatic special enrollment period and be allowed to

shop and enroll immediately

 If you complete an application online and you are not able to shop for a plan and

enroll into coverage right away, contact Health Connector Customer to request a

special enrollment due to COVID-19

• This enrollment window is open through July 23

unless you have a different qualifying

event that opens an enrollment window for 60 days. For example, you just lost coverage

from a job

• You need to apply, enroll and pay your first premium by the 23rd of the month before

your coverage can start. For example, enroll and pay by July 23

for coverage to start

on August 1 or September 1

• Free help with the application and plan selection process is available through the

Health Connector’s customer service and enrollment assisters across Massachusetts,

call today to make an appointment for help!

• Health Connector home page:

Helpful Resources

www.mahealthconnector.org

• Resource download page (Shopping Guides, Guide to Subsidies, ConnectorCare Overview,

Standardized QHPs):

www.mahealthconnector.org/help-center/resource-download-center

• Health Connector Provider and Prescription search tool: PlanFinder.MAhealthconnector.org

• Enrollment Assistance search: https://www.mahealthconnector.org/help-center

• Customer service information (call and walk-in centers):

https://betterhealthconnector.com/about/contact

• Small Business page: https://www.mahealthconnector.org/business/employers

• Coverage options for non-benefits eligible employees or former employees:

https://www.mahealthconnector.org/employer-resources

• Resources for newly unemployed:

• English:

www.mahealthconnector.org/wp-content/uploads/health-coverage-after-a-

job-loss-eng.pdf

• Spanish: www.mahealthconnector.org/wp-content/uploads/health-coverage-after-a-

job-loss-esp.pdf

Questions?

What are the income guidelines to get help from the

Health Connector?

Current Federal Poverty Level (FPL) guidelines used by the Health Connector

How do I enter my income if I’m unemployed?

When you complete an application you’ll be asked about your current

income as well as your estimated income for the year.

Type of Income

Include in Current Income?

Include in Projected Annual

Income?

Unemployment extension

to up to 39 weeks of

benefits

Yes, regular unemployment

should be reported as long as it is

received

Yes, make your best prediction

about your yearly income

accounting for how long you expect

to receive unemployment

$600 unemployment

“bump” (Federal

Pandemic Unemployment

Compensation)

No, do not include this amount in

the unemployment benefits you

report

Yes! Do add the $600 per week in

when reporting expected yearly

income. Someone on

unemployment from early April

through July 25 will earn about

$10,000 from this bump

One-time “recovery

rebate” or “stimulus

payment” of $1200 per

adult and $500 per

qualifying child

No, do not include this income No, do not include this income

Examples of ConnectorCare Plan

Premiums and Benefits