Chicago Tribune, February 27, 2014 - "Tales of Obamacare: From elation to frustration"
"Almost everything changed for Christine Williams in 2002.
In February that year, she and her husband, Joe, were laid off from their jobs in marketing and communications. Six weeks later, she gave birth to twin girls.
Then, in July, on the day after the twins were christened, she found out via an MRI that she had a brain tumor.
"At that moment — in the insurance world — I became uninsurable," said Williams, 48. An operation to remove the tumor was unsuccessful, she said, meaning she'd have to manage it the rest of her life.
Williams, who lives in the Mayfair neighborhood, said she still had coverage at the time under COBRA, the federal health insurance law. But after it ran out, she found her only choice was with the state's high-risk health insurance pool, called the Illinois Comprehensive Health Insurance Plan, or ICHIP.
Her premium alone was about $700 a month. Together with a private plan for her husband and daughters, the family's premiums neared $1,550.
As the Affordable Care Act takes effect, ICHIP is being phased out. But the law also meant insurers could no longer deny Williams coverage because of a preexisting condition.
Now the Williamses are all on the same insurance policy. The family is paying about $100 a month more than before — the plan includes new dental coverage for the girls — but Williams sees that as a small price to pay for the freedom it grants.
Williams can continue to consult her doctors at three hospitals in Chicago and one in Baltimore, including a neurosurgeon, a neuro-ophthalmologist, a retina specialist and a cornea specialist.
The other big relief is being on the same policy with her family.
"However insignificant it may seem to someone else, having to have my own policy — and not by choice — was always labeling me a liability in my eyes," she said. "There's a peace of mind that comes with this. … I can't put a price on that."
Andrea Lubershane, Evanston"
Illinois turning to insurance agents for Obamacare outreach"
January 16, 2015
Keith Kelly knew shopping health word would be complicated. So a 55-year-old Naperville male skipped a sovereign enrollment website and asked for assistance from someone he knew: an word salesman.
Kelly told word representative Robert Slayton about his underactive thyroid, his need for a chiropractor and other health specifics. After a lecture on deductibles, copays, drug costs and other word provisions, Kelly and his mother staid on a Blue Cross Blue Shield devise for that a integrate pays about $700 per month.
“There are so many variables, and (Slayton) put them into simply distinct piles for us to go by and make a possess sensitive decisions with his help,” Kelly said.
Insurance agents have so distant played a singular purpose signing people adult for Affordable Care Act word in Illinois, where a state has focused on federally saved navigators to surprise people about their options and assistance them buy skeleton or enroll in Medicaid.
But with destiny appropriation for a navigator module uncertain, a state is expanding a purpose of word agents in a overdo efforts.
Get Covered Illinois, a state’s enrollment arm, is spending about $150,000 this winter to assistance 13 word brokerages compensate for co-branded offered materials, pronounced Jennifer Koehler, Get Covered Illinois’ executive director. The site getcoveredillinois.gov lists about 150 word agents who have finished state training courses in Medicaid and information security.
Unlike navigators, word agents can ask people specific questions about their health and afterwards suggest a specific devise or insurer. Insurers compensate agents a elect on skeleton sold, customarily a elect of a premiums.
Consumers should be wakeful that creates an inducement for agents and brokers to sell higher-priced plans, pronounced Abe Scarr, executive of a Illinois Public Interest Research Group.
“There are not indispensably adequate protections in place to make certain that that’s not happening,” Scarr said.
Navigators are banned from usurpation payments from insurers. Consumers also can review skeleton on their possess by regulating a healthcare.gov website.
Agents contend their elect on health skeleton in Illinois is around 6 percent of premiums — most reduction than they accept for offered other forms of insurance. Sometimes insurers compensate a prosaic price instead.
The financial proclivity for agents could assistance consumers in a prolonged run by boosting a series of people with health insurance, pronounced Barbara Otto, CEO of Health and Disability Advocates, a nonprofit that has been concerned in state health initiatives.
“Who’s going to be enrolling populations after 2015, after 2016, after 2017? So we started investing in brokers,” Otto said. For some health word shoppers, a specific recommendations agents can offer make it easier to collect a plan, pronounced Slayton, boss of Naperville-based brokerage Robert Slayton Associates and a former boss of a Illinois State Association of Health Underwriters.
“An representative can do a same thing (as a navigator), though during a same indicate in time they can advise a chairman formed on their personal health on what they need,” he said.
Agents can also pull on their knowledge to assistance business collect an insurer, Slayton said. For example, an representative could tell a patron that one insurer typically pays claims some-more reliably than another.
Agents accept no elect for offered Medicaid plans. They customarily impute people who are authorised for Medicaid to navigators, several Chicago-area agents said.
The limitation on navigators recommending specific health skeleton is a product of negotiations between state officials and word representative groups before a sovereign marketplace came online, pronounced Phil Lackman, executive clamp boss of Independent Insurance Agents of Illinois.
“We still believe, in a infancy of cases, that consumers wish a assistance of an representative or broker,” Lackman said, while acknowledging that in some tools of a state there are few protected agents.
The sovereign supervision combined and saved a navigator module to enroll people in private skeleton and Medicaid, a state word module for a bad and disabled.
Illinois is spending about $25.8 million in sovereign income on some-more than 900 navigators’ salaries for a open enrollment duration finale Feb. 15. State health officials have practical for income to keep a module going during slightest by subsequent year’s open enrollment, though it’s misleading how most they will receive, state orator Mike Claffey said.
Small employers fastener with rising health word premiums Ellen Jean Hirst Chicago-based YJT Solutions isn’t compulsory to offer health word to a 35 employees, though it does. In fact, it covers 100 percent of a workers’ particular costs. Chicago-based YJT Solutions isn’t compulsory to offer health word to a 35 employees, though it does. In fact, it covers 100 percent of a workers’ particular costs. ( Ellen Jean Hirst ) –>
Agents have traditionally helped tiny businesses conduct health caring skeleton and are good matched to reaching a operative poor, a race that is critical for a health law’s sustainability, pronounced Otto, of Health Disability Advocates.
Of a 900,000 working-age Illinoisans who became authorized for word by a Affordable Care Act’s sovereign marketplace, usually about a entertain sealed adult during final year’s open enrollment period, according to an investigate of census information by Illinois Health Matters, a investigate arm of Health Disability Advocates. About 63 percent of a 900,000 are employed, according to a analysis.
“If we wish to strech that population, that is mostly a operative poor, we have to go to where they’re working. We have to be a tiny some-more innovative,” pronounced Otto.
Most of a employed people who are authorised for marketplace skeleton work for tiny businesses or franchises, according to a Health Disability Advocates report.
Insurance agents can assistance tiny businesses use a sovereign marketplace’s Small Business Health Options Program, famous as a SHOP marketplace, or can assistance workers collect skeleton away if their employer doesn’t offer insurance, a news suggests.
Making a distinction from offered Affordable Care Act health word skeleton is difficult, pronounced George Kleanthis, an representative with Woodridge-based Hartland Insurance Services, that started offered a skeleton in a stream open enrollment period. But offered that coverage helps find clients who competence be meddlesome in life, auto, home and other forms of word that compensate aloft rates, agents said.
Hartland has taken a identical proceed to enrolling clients that navigators have taken — environment adult tables during village events, going to churches and schools, holding town-square character meetings focused on health insurance.
“It’s a severe business to be essential in, though if we structure properly, and you’re means to scale a business, we can make money,” Kleanthis said.
This story was constructed in partnership with Kaiser Health News, an editorially eccentric module of a Kaiser Family Foundation.
Consumers’ Checkbook Allows Illinois Residents to Compare Plans Side-by-Side and Make Informed Plan Choices"
January 20, 2015
Get Covered Illinois Partners with Health Advocates to Provide Enrollment Tool to Help Educate Consumers
CHICAGO – Get Covered Illinois (GCI) today announced its partnership with The Chicago Community Trust and the Sargent Shriver National Center on Poverty Law to provide a new enrollment counseling tool via the Consumers’ Checkbook/Center for the Study of Services (CSS) that will help educate consumers about health coverage.
The Consumers’ Checkbook is a one-of-a-kind comparison tool that will be available on the GCI website, GetCoveredIllinois.gov. The tool is designed to help consumers navigate their health coverage options, choosing the plan that is most likely to help meet their individual needs and budget.
“This new tool evaluates plans on a variety of features, including cost, risk and quality, to develop recommendations specific to each consumer,” said Jennifer Koehler, executive director of GCI. “This makes it ideal for GCI’s Navigators, agents and brokers who are committed to helping their clients explore all of their options and make smart health care decisions.”
The cost-comparison function is an especially valuable resource for consumers because it analyzes more than just premiums or deductibles to determine the total cost of each plan. In addition, it also provides estimates on the total average costs for someone like the consumer and his or her family by including additional out-of-pocket costs, like copayments, coinsurance and more. This can result in savings of up to $3,000 or more per year for consumers.
“The Consumers’ Checkbook tool will allow thousands of Illinois residents to compare health insurance costs and the quality of plans in a time-saving manner,” said Alma Rodriquez, associate program officer of The Chicago Community Trust. “The Chicago Community Trust is supportive of the State’s efforts to ensure that the enrollment process is accessible and manageable for all.”
This tool is one of many improvements to the GCI website in Year Two, making more resources available to help Illinois consumers learn how to purchase, use and renew their health coverage. Illinois residents can also use the website to locate enrollment events and in-person help in their community. GCI employs a network of hundreds of trained Navigators and has teams of agents and brokers ready to help enroll.
With more plans on the Marketplace than ever before, GCI is focusing on the importance of in-person help and using the tools available to help consumers understand their plan options. Since Nov. 15, more than half of Illinois enrollees are new. This includes people who may have never had insurance before and are unaware of the different aspects to purchasing coverage.
“The Consumers’ Checkbook tool will help to level the playing field for Illinois consumers who have never bought insurance on their own or with the help of an employer so they can evaluate the hundreds of plan choices in the Marketplace. This is especially useful for low-income consumers who may have been priced out of insurance in the past,” said Stephani Becker, senior policy analyst for the Sargent Shriver National Center on Poverty Law. “Giving these consumers a tool to help them understand their options – including what a plan could cost them in the long- and short-run — is extremely valuable.”
GCI is off to a strong start in the second Open Enrollment Period. Recent reports from the U.S. Department of Health and Human Services (HHS) show that more than 121,000 Illinois residents signed up for health coverage in the first month. The report also showed that roughly 80 percent of Illinois enrollees received financial help paying for coverage. More than 800,000 Illinoisans total have enrolled in health coverage during the last 15 months.
The Open Enrollment Period began on Nov. 15 and runs through Feb. 15. Illinois residents can enroll today by meeting with a free, trained specialist in-person or calling the GCI Help Desk at (866) 311-1119. Visit GetCoveredIllinois.gov for more information or to find a certified Navigator, agent, broker or application counselor near you.
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About Consumers’ Checkbook:
Consumers’ Checkbook/Center for the Study of Services, founded in 1974, is a 501(c)(3) nonprofit organization whose mission is to inform and educate consumers about the quality and cost of service providers and how to select and deal with such providers. Checkbook/CSS publishes magazines and books and has websites to make its ratings and reports on service providers widely available to consumers. None of its publications nor websites (www.checkbook.org) carries any advertising.
About The Chicago Community Trust:
For 99 years, The Chicago Community Trust has connected the generosity of donors with community needs by making grants to organizations working to improve metropolitan Chicago. In 2013, the Trust, together with its donors, granted more than $160 million to nonprofit organizations: developing new audiences to sustain Chicago’s vibrant arts organizations, protecting the human services safety net for those hardest hit by the recession, stemming the devastating effects of foreclosures on our communities, elevating teaching to meet world class standards, and improving conditions for healthy and active lifestyles. As nonprofit organizations, local governments and businesses strive to tackle issues of concern, the Trust provides civic leadership bringing all stakeholders to the common table. Working together, the Trust, its donors and its community partners leverage collective knowledge, creativity and resources for a greater impact than any of us can make alone.
About Sargent Shriver National Center on Poverty Law:
The Sargent Shriver National Center on Poverty Law provides national leadership in advancing laws and policies that secure justice to improve the lives and opportunities of people living in poverty. The Shriver Center works to ensure that laws and policies provide people with low-income access to adequate health care, decent housing, a safety net, and opportunities to achieve their full potential. It advocates positive policy and systems changes on a range of issues, including asset building, budget and taxes, community justice, economic justice, education, health care, housing, and challenges facing women and girls.