Since the federal online marketplace for health insurance opened in October, media reports have focused on its technical glitches.
Chris Casazza, whose job is to guide Sussex County residents through the health insurance marketplace, says the system is improving.
Casazza provides a free service to residents of Sussex County – he will go anywhere, even to people’s homes, to answer questions and help residents sign up for more comprehensive, less expensive medical insurance.
Easton, Md.-based nonprofit Delmarva Foundation for Medical Care is contracted by the state of Delaware to guide insurance shoppers through the online marketplace.
For the last two months, Casazza, Sussex County supervisor, has been making the rounds at local libraries, churches, CHEER centers, providing outreach and enrollment assistance.
Casazza said he and his small staff are not agents or brokers. “I don’t have a number I have to hit,” he said. He and his staff get no commission for enrolling people in health insurance. Casazza said beware of anyone who asks for compensation for the service.
So far, he said, he has guided fewer than 100 people in Sussex County through completion of purchasing insurance, but he expects to help many more.
Casazza said he is still in the process of getting many of his staff members certified to guide Sussex residents through the marketplace. Once he is fully staffed, he said, he expects the number of people signing up for health insurance to jump significantly. “The response has been very, very positive,” he said.
Those who have signed up, Casazza said, are mostly working families and individuals who already had insurance, but found they could save money by using the online marketplace. “They are just excited there’s a new option,” he said. “I’ve had consumers who have had extraordinarily significant savings.”
Much of cost savings comes from tax credits and cost sharing of deductibles and co-payments, he said.
The income eligibility for individual Medicaid coverage in Delaware rose from $11,800 to $15,500 after the law was passed, Casazza said. That means about 30,000 more Delaware residents ages 19-64 will be eligible for Medicaid coverage, he said – but they have to sign up.
Casazza said the biggest roadblock so far has been massive media attention drawn to problems with the national health insurance website.
The health insurance marketplace is not complicated, Casazza said. “It’s just a huge program,” he said. “It’s going to take a small period of time to work the kinks out.”
Casazza said the system gives real-time insurance eligibility results and has increased its capacity to handle up to 50,000 consumers at once.
He said the application process is now much faster. “If it’s running smoothly…30 minutes is about what me and my staff need to get it taken care of,” he said.
Eligibility is determined by income, family size and tobacco use, he said. In some states, geography can play a factor, Casazza said, but not in Delaware.
Affordable Care Act in Delaware
Congress passed the Affordable Care Act in March 2010. The law requires individuals to have health insurance and requires most businesses to provide health insurance for employees.
Under the law, insurance companies must provide customers with 10 essential health benefits, including mental and behavioral healthcare, substance abuse treatment, preventative services, pediatric care and maternity care.
The law also forces insurance companies to treat all individuals equally; for example, women can no longer be charged more than men for health insurance, Casazza said.
Penalties for individuals who do not sign up for insurance – $95 or 1 percent of the individual’s income – begin in 2014.
In 2015, the penalty jumps to $325 or 2 percent of an individual’s income. By 2016, those who do not buy insurance will pay $695 or 2.5 percent of their income, whichever amount is greater.
Adults will also be required to pay penalties for uninsured dependants, Casazza said.
The law provides certain exemptions for hardship, religion, income, incarceration or tribal membership, he said.
For businesses, penalties begin in 2015. Small businesses with fewer than 50 full-time employees are exempt from the penalty. Also, Casazza said, if a business has more than 50 employees, but insurance will cost more than 9.5 percent of the business’s annual income, it is considered a hardship, and the company does not have to offer insurance.
Insurance shoppers can enroll online using the federal website at Healthcare.gov or the state website at ChooseHealthDE.com. Any other site will extract personal information and use it for data mining, Casazza said.
Sussex County residents can call Casazza at 302-853-5524, email him at firstname.lastname@example.org or stop by his office at 528 East Market St. in Georgetown.
“I want to reach everybody,” he said.