NC insurance advocates ramp up as ACA enrollment begins

The marketplace for subsidized health insurance under the Affordable Care Act opens Saturday for its second round of sign-ups, and North Carolina advocates hope to build on their experience of attaining the nation’s fifth-highest enrollment last spring.

Organizers plan enrollment promotions Saturday throughout the state at churches, clinics, shopping centers, community centers, farmers markets and other public venues. Enrollment efforts will continue for the next three months.

The enrollment period will be shortened this time from six months to three months, ending Feb. 15. Those who want insurance by Jan. 1 will have to buy coverage by Dec. 15.

At the same time, North Carolina will have three health insurers offering subsidized policies instead of two, though not all three will operate in all 100 counties. Subsidized coverage is available from Blue Cross and Blue Shield of North Carolina, Coventry Health Care of the Carolinas and UnitedHealthcare.

UnitedHealthcare announced Friday that it will offer 10 plans in 77 counties in North Carolina.

Because the Affordable Care Act requires most Americans to have health insurance, financial penalties await many who opted out of buying health insurance this year.

The penalties increase significantly in the second year of the law, with the minimum fine for an individual rising from $95 this year to $325 next year. Some could be subject to a fine equaling 2 percent of their income above the federal tax filing threshold, unless they can qualify for an exemption.

From October 2013 to April 2014, about 357,584 people in North Carolina selected a plan on the federal exchange, but some never followed through with a purchase and others dropped coverage in subsequent months. In this state, 91 percent qualified for subsidies – called premium tax credits – to reduce their monthly payments.

ACA advocates are emphasizing the subsidy benefits for low-income applicants, said Sorien Schmidt, N.C. director for Enroll America, a nonprofit organization. Schmidt said this data was not available last year and will help persuade skeptics to consider signing up.

According to federal data, 71 percent of North Carolina residents who bought subsidized plans had premiums of $100 a month or less, and 48 percent paid $50 a month or less in monthly premiums.

Those who didn’t qualify for subsidies because their income was too high have expressed concern over steep rate increases year after year as health care costs continue to rise by double-digit percentages.

Schmidt said that those who have already subsidized insurance should update their household incomes on their online accounts because the subsidy guidelines have changed slightly, as have the details of some health insurance plans.

Rates will go up for many plans, and other details may change. For instance, the maximum allowable out-of-pocket costs are rising from $6,350 to $6,600 for an individual and from $12,700 to $13,200 for a family.

Additionally, the minimum qualifying income for subsidies for an individual will increase in the second year of enrollments from $11,490 to $11,670, and for a family of four from $23,550 to $23,850.