Affordable Care Act Update in the Kingdom of Illinois

It’s December 19th, do you know where your healthcare is?  I’m sure you all think this is all I talk about, but it’s almost over.  December 23rd is the LAST day of enrollment to be covered for January 1st.  (yes, people were calling me yesterday asking when they should sign up. They are getting poison apples for Christmas) sand timer redDon’t wait any longer, this isn’t a smooth process and the wait times for help is long.  I needed questions answered from my friends at Blue Cross and I waited 2 hours and 44 minutes before I spoke to someone.  When she did pick up, she was lovely and answered all of my questions.  They are overwhelmed so be nice when you get through. Santa is watching!

There is a late breaking development that I wanted you to be aware of in Illinois. There are between 19,000 and 30,000 applications that may need to be redone because of calculation glitches.  Here’s what the State of Illinois is saying “Get Covered Illinois (GCI) is advising people who have applied for coverage on the federal web site, healthcare.gov, and who believe they may have been incorrectly referred to the state for Medicaid coverage, to restart the process by using the screening tool at Getcoveredillinois.gov.”  (Read the link to the full announcement here)  

Why does this matter?  If you  or one of your employees were put into this group and wrongly put in Medicaid you are denied subsidy while waiting for appeal.  Or you will be in the wrong category and it will need to be adjusted later.  HHS is not sure how long is process will take.

Per  Jayne O’Donnell in USA today – “HHS expects about 19,000 files shortly from HHS. Illinois state spokesman Mike Claffey says he doesn’t know how many may have problems”.  (Great article, link here)

Here are some Frequently Asked Questions:question mark

Is my Insurance effective January 1st? – If you have completed your application, received confirmation and PAID your premium.

What if I haven’t paid for my insurance yet? – NOTHING is in effect until the first month’s premium has been processed.  Follow up if you haven’t paid.  Keep your proof of payment.

I don’t have cards yet, but I’m paid, what now? – WAIT! Understand that this was supposed to be a three-month process but was cut down two months because of the website.  Healthcare.gov and all the insurance companies and trying very hard to do three months of work into 3 weeks, cards will take a while.  Doctors and Hospitals should understand if you have an emergency.  I estimate cards won’t be distributed until 2nd week of January (just a guess).

I’m on ICHIP and selected a new plan, am I done? – NO, you have to notify ICHIP that you are not staying on their plan and have a new ACA plan.  I just heard about the notification.

What is the most important thing to look at when choosing a plan? – Deductible, Network and Drug Card.  These three pieces are like cut, color and quality in diamonds.  The pricing will change dramatically by changing any of these dynamics.  If you are looking at a PPO with the same deductible and co-pays and there is a $200 difference in price, it’s probably the network.

I’m looking forward to Christmas this year because my present is the end of enrollment for the Affordable Care Act.  

It’s been a great year, Happy Holidays my pretties! 

Now go make sure you signed up and paid!

About evilqueenhr

Once upon a time there was a boring HR person sitting in a back office filling out paperwork spouting sections from the handbook. I’m not that HR person. Work is a scary and sometimes funny place with lots of lessons to learn along the way. People don’t follow the rules, it’s HR’s job to steer them in the right direction. Unfortunately there are no apples with spells to make the bad employees fall asleep until we can recruit new ones. My Name is Denise Benages and I have been in the Human Resource field for over 16 years. I am president of HR Midwest, Inc. I plan on telling the epic lore of the workplace and help with solutions. Don't Bite the Apple...Work is not a fairy tale! www.dontbitetheapple.net www.hrmidwest.com
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