What you need to know about the changing Connecticut Health Marketplace

The Connecticut Health Marketplace is still going strong.

With all the talk and legislative furor, you might have expected the ACA and the Connecticut Health Marketplace to implode by now. With a few exceptions, the system is unchanged and still going strong. Access Health CT is still the only resource in the state for individuals, families and small businesses to apply for coverage.

Since the inception of the Affordable Care Act, Connecticut Health Marketplace reduced the state’s uninsured rate by 45%. Despite attempts to terminate ACA coverages, Connecticut Health Marketplace enrollment was higher for 2018 than in the prior year.

Here are a few additional facts you should know about the changing Connecticut Health Marketplace.

2019 Rate Changes

The federal Individual Mandate elimination and the uncertainty concerning access to short-term and associated health plans have inspired additional rate increases. The two insurers who plan to offer coverage through the Connecticut Health Marketplace have filed for 2019 rate increases.

The Connecticut Department of Insurance will rule on CTCare Benefits requested 13% increase and Anthem’s requested 9.1% increase this September.

Connecticut General Assembly ACA Legislation

In May 2018, the General Assembly passed CT HB-052101. The bill mandated 10 essential benefits coverages, expanded benefits for women, children, and adolescents, and expanded previously mandated contraception benefits.

SB206 approved pregnancy as a “qualifying event.” The bill became law on June 1, 2018, after the governor failed to sign it.

The General Assembly rejected implementation of a state Individual Mandate and a proposal to request federal funding for a state reinsurance program.

Associated Health Plans

Pending federal rule changes that allow easier access to Association Health Plans may reduce the pool of insureds both in the individual and SHOP markets. AHPs allow self-employed persons and small businesses to purchase insurance together as a group. The process of pooling individuals and separate business entities into a larger group makes them eligible for discounted rates.

The drawbacks? AHPs may provide less comprehensive coverage. The plans may reject group members with health issues or charge them a higher premium.

Plan Subsidies

Federal Subsidies and tax credits available through Connecticut Health Marketplace plans remain one of AHA desired premium benefits. Connecticut’s Silver Plan cost Sharing reduction benefits were higher in 2018 and will be even more generous for 2019 premiums.

Earlier this year the IRS announced a small business health care tax credit for businesses without access to a health marketplace in their area.

An individual or family enrollee can determine if they qualify for a subsidy by using the Obamacare (Yes, they still call it that) Subsidy Calculator at healthinsurance.org.

Small Business Health Options Program

Small businesses with 1 to 50 workers can still obtain Small Business Health Options Program (SHOP) medical and dental plans with Anthem or CTCare. Businesses may enroll online at the Connecticut Health Marketplace at accesshealthctsmallbiz.com. Business owners who require professional assistance can apply through a Certified Broker.

Open Enrollment

2019 Connecticut Health Marketplace Open Enrollment begins on November 1, 2018, and ends on December 22, 2018, at accesshealthct.com. Plans are effective January 1, 2019.

Pregnancy is new to the list of “qualifying events” which meet special enrollment guidelines. Native Americans may still apply at any time.

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