Health Insurance and Care Options Guidance

Explore insurance and health care options for 2021-2022, including COBRA coverage, family plan considerations, maximizing benefits under the American Rescue Plan, and the importance of ACA compliant policies for comprehensive coverage.

• Health insurance
• Health care
• COBRA
• American Rescue Plan
• ACA compliant

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1. INSURANCE & HEALTH CARE OPTIONS Prepared by: Rebecca Ross, Agency Liaison, PIR Revised September 30, 2021

2. Message from Oklahoma Insurance Department NOTE The following presentation contains programs and benefits that are specific to 2021 and 2022 in eligibility for enhanced premium assistance. Please check with the appropriate federal and state websites for more information and updates as noted on the slides. Thank you

3. Check COBRA Option Your group insurance will cover you through October You will receive a COBRA packet explaining your options and premium costs so you can begin COBRA in November if you so choose. Remember, COBRA coverage effective dates are retroactive to your group insurance coverage termination date. Most who choose COBRA want to continue specialized treatment with a Network Provider Pay close attention to your COBRA deadlines to apply and pay your first premium. These are hard deadlines.

4. Check Family Options Spouse Employer Plan You or other dependents can be added, find out: Time frame to enroll Benefits/Network Premium cost (deducted from spouse s check) Not Yet Age 26? Can be added to one of your parent s plans Find out time frame to be added Don t have to live or be dependent on them nor be in college You can be married but your spouse/child(ren) won t be covered with you.

5. Apply for Unemployment Insurance to Maximize American Rescue Plan Benefits Your UI will be your income on www.healthcare.gov Other sources of income must be reported too, if you have any, including other taxable household members You will want to be approved and receive UI benefits for at least any ONE week in 2021 to maximize your benefits under American Recovery Act through 2022.

6. ACA Compliant Policies Protect You Individual and Group ACA Compliant Policies must provide: Hospitalization Emergency Services (ex, ground transport) Ambulatory patient services (physician office visits) Maternity/Newborn care Mental Health/Substance Abuse Services/Treatment Prescription Drugs Rehabilitative and habilitative services/devices Laboratory services Preventive/wellness service including chronic diseases Pediatric Services including oral/vision care

7. American Rescue Plan Premiums Substantially Reduced for ACA Compliant Individual Policies on www.healthcare.gov Household Income Range (% of FPL) NEW!!! Range of Your Expected Contributions (Premiums) for 2021/2022 under American Rescue Plan 138%-150% 0% 150%-200% 0% - 2% 200%-250% 2% - 4% 250%-300% 4% - 6% 300%-400% 6% -8.5% 400% and higher NEW!! 8.5% https://www.cms.gov/newsroom/fact-sheets/american-rescue-plan-and-marketplace

8. American Rescue Plan Action Items Did you receive your Employer Notice of COBRA eligibility? If continuing coverage, did you turn in your COBRA election forms? Remember, you are responsible for paying the entire COBRA premium (102%), unless your employer tells you otherwise. Have you applied for UI so you can begin your UI benefits? Apply on www.healthcare.gov for Individual Plans (can cover family) to receive zero or reduced premiums for rest of 2021 During Open Enrollment Nov 1-Dec 15*, for coverage beginning 2022, new, renew or change plans to continue receiving zero or reduced premiums. https://www.dol.gov/agencies/ebsa/laws-and-regulations/laws/cobra/premium-subsidy Enrollment date could be extended one month so watch for changes on www.healthcare.gov

9. Other Types of Individual Insurance Non-ACA Compliant Plans: NOT Comprehensive Medical Plans Will ask medical questions and can deny coverage Examples: Short-Term Limited Duration Plans Accident Only Plans Hospital Indemnity Plans Disease Specific Plans and other types of Limited Benefit Plans.

10. Health Care Plans NOT Insurance Are not regulated by OID and have NO Consumer Protections: Health Care Sharing Ministry Plans Discount Plans, i.e., Medical, Dental, Vision, RX cards, Hearing Aids Membership Plans - you pay a monthly fee to receive primary care services from a specific provider, group or facility

11. Other Government Plans Veteran's Administration Benefits SoonerCare (Medicaid in Oklahoma) Enrollment 24/7 at www.mysoonercare.org Covers children up to age 19 Expanded Medicaid under SoonerCare now covers adults ages 19-64 For example, incomes at or below $17,796 (single household); $36,588 (family of 4), other incomes according to family size are viewable at www.mysoonercare.org

12. Contacts Your employer or plan administrator for questions about COBRA Your spouse s employer to get coverage info & enroll Your parents if under age 26 to get coverage & enroll under one of their plans www.mysooner.org to enroll yourself &/or family Need Help? On www.healthcare.gov from the home page you can find an Agent/Broker to assist you, just enter your zip code to find local help. Oklahoma Insurance Consumer Assistance 1-800-522-0071

13. Oklahoma Insurance Department | Insurance Commissioner Glen Mulready | 800.522.0071