A new health exchange wants to help the uninsured

By Veronica Burns

It is estimated that there are 344,000 individuals in the state of Connecticut who either do not have any health insurance or are underinsured. That should start to change on October 1, when open enrollment begins as part of the implementation of the Patient Protection and Affordable Care Act. The enrollment will continue through the end of March next year.

Signed by President Obama in May of this year, the Affordable Care Act aims to provide coverage to millions of uninsured Americans. To help achieve that and to guide people through the complexities of the legislation, consumers now have access to a health insurance marketplace.

Access Health Connecticut, a quasi-public agency created in 2011, has joined with the state Office of the Healthcare Advocate to launch a Navigator and Assister Outreach Program. The program provides a one-stop-shopping marketplace for those who will require insurance under the new law. Last month, Access Health launched its toll-free call center. Consumers can speak with a representative by dialing 1-855-805-4325 between the hours of 8 a.m. and 8 p.m. Monday to Friday, and on Saturdays from 11 a.m. to 3 p.m. In addition to the call center, consumers can also find information on the group’s Web site (details below).

There are six Navigator organizations in Connecticut with New Opportunities, Inc. being the Navigator for our area. New Opportunities is a community action agency that serves Waterbury, Meriden and Torrington, as well as 27 surrounding towns, including Norfolk. The Navigators help consumers prepare electronic and paper applications to establish eligibility and enroll in coverage. Consumers can potentially qualify for an insurance affordability program. The Navigators supervise the Assisters but it is important to note, neither sell insurance. Consumers will instead be referred to a health insurance ombudsman or to consumer assistance programs when necessary.

According to information on Access Health’s Web site, no one will pay more than 9.5 percent of household income on health insurance. Some applicants will be capped at two to three percent. In addition, some applicants could qualify for a discount. The discounts come in the form of tax credits and consumers have access to a calculator on the Web site to determine what the costs and benefits might be.

One of the more controversial aspects of the Affordable Care Act involves a penalty for those who do not purchase insurance. In the first year a failure to have coverage will result in a $95 fine to be collected by the IRS, increasing in future years up to $325 in 2015 and $695 in 2016. Small businesses (those with fewer than 50 full-time employees) are exempt from providing insurance. But those that do choose to offer insurance may also be able to receive tax credits. Businesses with more than 50 employees have to provide insurance or pay a fine.

More information about Access Health Connecticut’s Navigator and Assister Outreach Program is online at AccessHealthCT.com.