Fillable ACA Paper Application

wwwOregonACA.com

Apply Now 2015 Plans

2015 Apply Now ACA
Health Insurance Companies
In The News
Networking Groups
Contact / Agent Info

A Real Person will Answer 9:00 AM to 8:00 PM

Call Doug Ellsworth

503-922-2903

This is not the official website for Cover Oregon, but as a Certified Agent with Cover Oregon I can answer your questions.  Please visit http://www.coveroregon.com for complete information and coverage options.

Coverage offered in the following cities and locations

A Real Person will Answer 9:00 AM to 8:00 PM

Call Doug Ellsworth

503-922-2903

Cascade Mountains

CITIES Brightwood, Camp Sherman, Cascade Locks, Cascadia, Chemult, Chiloquin, Crescent, Crescent Lake, Detroit, Diamond Lake, Drew, Estacada, Fort Klamath, Gates, Gilchrist, Government Camp, Idanha, Klamath Agency, La Pine, Lakeview, McKenzie Bridge, Mill City, North Umpqua, Oakridge, Prospect, Rhododendron, Sandy, Sisters, Sunriver, Warm Springs, Welches, Westfir, Zigzag
AREAS:  Crater Lake National Park, Deshutes National Forest, Fremont National Forest, Mount Hood National Forest, Rogue River National Forest, The Three Sisters, Umpqua National Forest, Willamette National Forest, Winema National Forest

Central Oregon
CITIES:  Antelope, Arlington, Bend, Brothers, Condon, Culver, Dufur, Fossil, Grass Valley, Hampton, Lonerock, Madras, Maupin, Metolius, Mitchell, Moro, Mosier, Paulina, Post, Prineville, Redmond, Rowena, Rufus, Shaniko, Spray, The Dalles, Wasco

Northeast Oregon
CITIES:  Adams, Arlington, Athena, Baker City, Boardman, Canyon City, Condon, Cove, Dayville, Echo, Elgin, Enterprise, Fossil, Greenhorn, Haines, Halfway, Heppner, Hermiston, Huntington, Imbler, Imnaha, Irrigon, Island City, John Day, Joseph, La Grande, Lexington, Long Creek, Lostine, Medical Springs, Milton-Freewater, Monument, Mt Vernon, North Powder, Oxbow, Pendleton, Pilot Rock, Prairie City, Richland, Seneca, Summerville, Sumpter, Ukiah, Umatilla, Union, Unity, Wallowa, Weston
AREAS Hell's Canyon

Oregon Coast
North Coast
Astoria, Bay City, Beaver, Cannon Beach, Garibaldi, Gearhart, Hebo, Nehalem, Manzanita, Neahkahnie, Oceanside, Pacific City, Rockaway Beach, Seaside, Tillamook, Warrenton, Wheeler
Central Coast
Depoe Bay, Dunes City, Florence, Gleneden Beach, Lincoln City, Mapleton, Newport, Otter Rock, Reedsport, Seal Rock, Siletz, Toledo, Waldport, Winchester Bay, Yachats
South Coast
Agness, Bandon, Brookings, Charleston, Coos Bay, Coquille, Gold Beach,
Lakeside, Myrtle Point, North Bend, Port Orford, Powers, Wedderburn

Portland and Vicinity
Banks, Barlow, Beaverton, Camas, Canby, Clackamas, Clatskanie, Columbia City, Cornelius, Forest Grove, Gaston, Gresham, Happy Valley, Hillsboro, Lake Oswego, Marquam, Milwaukie, Molalla, North Plains, Oregon City, Portland, Rainier, Sandy, Scappoose, St. Helens, Tigard, Troutdale, Tualatin, Vernonia, West Linn, Wilsonville

Southeast Oregon
Adel, Adrian, Burns, Diamond, Drewsey, Frenchglen, Hines, Jordan Valley, Juntura, Lakeview, Nyssa, Ontario, Plush, Vale

Southern Oregon
CITIES Ashland, Butte Falls, Cave Junction, Canyonville, Central Point, Dillard, Drain, Eagle Point, Elkton, Glendale, Glide, Gold Hill, Grants Pass, Jacksonville, Klamath Falls, Malin, Medford, Merlin, Myrtle Creek, Oakland, Phoenix, Prospect, Riddle, Rouge River, Roseburg, Shady Cove, Sutherlin, Talent, Umpqua, White City, Winchester, Winston, Wolf Creek, Yoncalla
AREAS:  Applegate Valley, Illinois Valley

Willamette Valley
Albany, Alsea, Amity, Aumsville, Aurora, Brooks, Brownsville, Canby, Canyonville, Carlton, Corvallis, Coburg, Cottage Grove, Creswell, Culp Creek, Dallas, Dayton, Detroit, Donald, Dundee, Eugene, Falls City, Gates, Gervais, Halsey, Harrisburg, Independence, Jefferson, Junction City, Keizer, Lebanon, Lowell, Lyons, McMinnville, Mill City, Millersburg, Mt.Angel, Molalla, Monmouth, Newberg, Oakridge, Oregon City, Philomath, Salem, Scio, Scott Mills, Sheridan, Silverton, Sodaville, Springfield, Stayton, St. Paul, Sublimity, Sweet Home, Tangerit, Turner, Veneta, Walterville, Waterloo, Willamina, Woodburn, Yamhill

Key words when looking for information on the CoverOregon Health Insurance Exchange.  Most people search for Free Obama Health Care in Oregon, or Obama Care Oregon, or Low Cost Obama health insurance, or Obama free health insurance oregon.  This site has all the information needed at this time with Low Cost options prior to Free Low Cost Obama care health insurance.

OregonACA.com


"Click Link"

Browse for Tax Credits


Key Websites

Cover Oregon

1-855-268-3767


OHP/Medicaid

1-800-699-9075

503-945-5772


 

http://www.OregonACA.com

 

 

HealthCare.gov

800-318-2596


 

Breaking News

 
 

 


   Health Benefits Solution, Inc

   Cover Oregon Health Insurance Exchange


CoverOregon Health Insurance Exchange, ACA Affordable Care Act, Obama Care

Fax Completed Application to 503-488-5597 or Toll Free 1-877-722-2378

Open Enrollment Starts November 15th, 2015

 

"Click this Link"

2015 Apply Now!

HealthCare.gov

 
 

Health Insurance Companies 2014 Health Plans

Open Enrollment Starts November 15th, 2014 and Ends February 15th, 2015

STM Short Term Medical

Agent of Record Consent Form

Careington Dental Fee Schedule

$11.95 Online Application

Careington Provider Lookup

IMG Travel Medical Insurance

IMG coverage brochure

Dr. Dan Thompson, Recommended Dentist for most all Dental Coverage "Click this Link"

My time and services are free and I am available 9:00 am to 8:00 pm 7 days a week.

Talk With A Real Person! 

Doug Ellsworth Certified Agent NPR# 7139388 Will Answer Your Questions

503-922-2903

Doug@MyOregonAgent.com

Currently the Cover Oregon software and website portal to see plans and rates, including Tax Credits are only available to Agents and Community Assisters, and the public will have access later in October 2013

As a Certified Agent with HealthCare.gov and the Federal Market Place I can explain Obama Care Plans available November 15th, 2015 and let you know if Tax Credits and Reduced premiums are available, and what Health Insurance will cost for you! 

If you would like my help just click the link below and e-mail your request for help in October, or any questions that I can answer now! If you call I will Answer!

Help Me Set Up Obama Care Health Insurance Plans in Oregon

About the Carriers in Oregon and plans offered in counties

Use our Individual Calculator and Plans to estimate your 2014 health care costs

through Cover Oregon Exchange Plans.

Prior to Oregon's Health Insurance Exchange, Health Benefits Solution, Inc can offer and explain the best health insurance options available in Oregon for Child Only, Individual, Family and Small Business offering major health coverage, vision, prescriptions and dental coverage.

Visit http://www.MyOregonAgent.com for health insurance options

Health Benefits Solution, Inc is a leader in offering health insurance coverage for all individuals, and small business in Oregon.  The Affordable Care Act and CoverOregon will offer affordable health insurance options to all Oregonians.

The purpose of this webpage is to help share the information on the Oregon Health Insurance Exchange, and the Affordable Care Act signed by President Obama. All information on this webpage is collected and shared from websites currently explaining progression of the Oregon Health Insurance Exchange including but not limited to http://www.CoverOregon.com Please visit this official website for all and current information.

Things to know about Oregon’s health overhaul

open enrollment

Open enrollment is the period when those previously uninsured can sign up for insurance, and those who already have coverage can change plans or insurance companies. Open enrollment runs from Nov. 15, 2014, to Feb. 15, 2015. Individuals who experience a special life event, such as marriage or the birth of a child, can buy coverage or change plans outside of open enrollment.

IF YOU ALREADY HAVE INSURANCE THROUGH COVER OREGON

All Oregon residents who previously enrolled in a private plan via Cover Oregon must re-enroll via HealthCare.gov. Those who do not want a break in coverage come January must re-enroll by Dec. 15 for coverage starting Jan. 1.

IF YOU WANT PRIVATE INSURANCE

Residents buying private insurance for the first time who think they qualify for a tax credit must use HealthCare.gov to shop for plans and enroll. Americans making less than 400 percent of the federal poverty level are eligible for a subsidy, also called advanced premium tax credits. Those who don’t believe they qualify for a subsidy can buy coverage outside the exchange, directly through carriers.

IF YOU QUALIFY FOR MEDICAID

Low-income residents eligible for the Oregon Health Plan, the state’s version of Medicaid, can enroll year-round. Until Nov. 15, they will use the hybrid manual-online enrollment process developed by the state. Starting on Nov. 15, they must use HealthCare.gov to apply for OHP. Some people, including pregnant women, refugees and people with disabilities, will continue to use the hybrid manual process even after Nov. 15.

IF YOU own a SMALL BUSINESS

Small-business owners can still receive tax credits when they offer insurance to their employees. To gain access to the subsidy, business owners should work directly through an insurance broker. Oregon will not be using the federal SHOP program on HealthCare.gov for 2015.

WHEN COVERAGE STARTs

For those who qualify for Medicaid, coverage starts immediately. For those who enroll in private insurance between the first and 15th of the month, coverage starts the first day of the next month; those who enroll between the 16th and the last day of the month will have coverage the first day of the second following month. Residents who choose a plan by Dec. 15 will have coverage starting as early as Jan. 1.

WHAT’S THE PENALTY FOR LACK OF INSURANCE?

People who don’t have health coverage during 2015 may have to pay a penalty. The penalty in 2015 is higher than it was in 2014 — 2 percent of a person’s income or $325 per adult ($162.50 per child), whichever is greater. The penalty amount increases every year until 2016 when it reaches $695 per adult or 2.5 percent of income.

WHAT WEBSITE TO USE

Most residents should use HealthCare.gov — though CoverOregon.com will continue as a source of information. The old website will also connect residents to community partners, navigators and insurance agents and will allow people to make appointments with them online via a finder tool. Residents can also go to OregonHealthCare.gov to get enrollment information. Both sites will redirect people to the federal portal, HealthCare.gov.


What Oregon Residents Need to Know About Obamacare

 

Welcome to the fastest way to find out about Obamacare in Oregon.

Here, you'll find clear and accurate information about Obamacare, including:

  • whether or not you must get health insurance
  • what the available plans cover
  • how much coverage will cost
  • how to sign up for a plan, and
  • how to get help if you need it.

To begin, keep in mind these key points about Obamacare in Oregon:

1. You must have health insurance, unless you qualify for an exemption.

The Affordable Care Act requires you to enroll in a health insurance plan unless you qualify for an exemption from the law. You will report whether you have coverage -- or whether you are exempt -- when you file your taxes in April.

Open enrollment for 2014 has ended, but you may still be able to get coverage for the end of 2014 if you qualify for a special enrollment period. If you don't, you can sign up for 2015 coverage during the open enrollment period that runs from November 15, 2014 to February 15, 2015.

 

To learn whether your current health plan satisfies the requirements of Obamacare or to find out whether you qualify for an exemption, see Do I Need to Get Obamacare in Oregon?

2. You can shop for affordable health care plans at HealthCare.gov.

Residents of Oregon will use the website HealthCare.gov to choose their Obamacare plan, apply for cost-saving subsidies, and get other help they need.

If you are currently uninsured, you can use the state marketplace to compare plans and enroll in a plan that meets your needs.

If you already have health insurance, either as an individual or through your job, you may be able to keep your current plan -- or you can use HealthCare.gov to shop for a new one.

If you want to switch from an existing plan to a marketplace plan, see "What if I already have health insurance?"

To learn more about enrollment, see How Do I Sign Up for Obamacare in Oregon?

3. You may qualify for subsidies that will save you money.

Many people who use the online marketplace to sign up for health coverage will be eligible for cost savings. Savings are available in the form of new tax credits to help you lower your premiums or reduce your out-of-pocket costs for care.

If your income is very low, you may qualify for free or low-cost coverage through Medicaid in Oregon.

For more information, see Ways to Save Money on Obamacare in Oregon.

For an overview of how much health care plans cost under Obamacare, see How Much Does Obamacare Cost in Oregon?

4. If you signed up for a 2014 health plan using Cover Oregon, you must re-enroll at HealthCare.gov for 2015.

Due to the shutdown of Cover Oregon, individuals and families who purchased private insurance plans through the state's former exchange will have to re-enroll through HealthCare.gov during the upcoming open enrollment period, from November 15, 2015 to February 15, 2015.  If you don't re-enroll, your insurance coverage will continue, but any financial assistance you've been receiving will end. 


 

More than $303 million in state and federal funds have been sunk into the project so far. Oracle collected $134 million to build the online exchange. The process of assessing blame for the failure of Cover Oregon often has focused on the role of Oracle, which was the primary technology provider and implementation consultant on the project. However, Oracle never had the authority to act as system integrator, a role state IT leaders decided to take on themselves. State and federal investigations pointed to inadequate oversight and project management as problems. State of Oregon CIO Alex Pettit, who was assigned to help rescue Cover Oregon, said that in addition to costing too much, a project to repair the site in time for the next open enrollment period beginning in November was too risky.

[Who's to blame for the rough rollout of HealthCare.gov? Read Kathleen Sebelius: Failed IT Project Manager?]

The Cover Oregon website eventually performed well enough to provide some services to insurance agents but was never judged adequate for use by the public. Instead, all Obamacare enrollments had to be processed on paper or through other workarounds.

This is a reversal of how the health insurance exchange feature of the Affordable Care Act was supposed to work. The original Obamacare vision was that every state, or at least the vast majority of them, would operate its own exchange. In retrospect, it's easy to wonder whether that was ever agood idea, given that many of the state sites have struggled. There have been a few happy exceptions in states such as Connecticut and Kansas.

Oregon's health insurance exchange will shut down, sending state residents instead to the federal HealthCare.gov website -- which, for all its troubles, looks good in comparison with a state site that never enrolled a single consumer.

The board of Cover Oregon, the quasi-public agency that ran the state health insurance exchange, on Friday voted unanimously to accept a recommendation to move to merge its website into HealthCare.gov.

As reported by the Oregonian newspaper, the state had been moving toward having Deloitte overhaul the website and related back-end systems, but pulled back after the estimated cost ballooned to more than $78 million. A panel evaluating the costs concluded that a switch to the federal exchange could be accomplished for $4 million to $6 million. The one component of the state-run system to be maintained would be for enrollment in Medicaid for those eligible.


Oregon's transition to federal exchange on track

PORTLAND, Ore. (AP) - As the start of the second open enrollment period for health insurance under the federal Affordable Care Act nears, Oregon officials say this time the state will avoid an enrollment disaster.

When Oregon launched its insurance exchange portal last October, it turned into a technology fiasco. Cover Oregon was the only exchange in the nation that never fully launched and didn't let the public enroll in coverage in one sitting.

Instead, residents had to use a time-consuming hybrid paper-online application process to get health insurance. Six top officials connected to the Cover Oregon debacle resigned.

The state abandoned its troubled exchange in April after determining it was cheaper to switch to the federal site than to fix Cover Oregon. Officials say they've taken steps to ensure a smooth new enrollment period, which starts on Nov. 15.

This summer, Oregon hired a tech firm, Deloitte Consulting LLC, to help transition Oregon to the federal exchange and to finish building the state's Medicaid system.

And earlier this month, officials cut all remaining ties with the state's main technology contractor Oracle Corp. and decided to use another state's Medicaid enrollment system instead of salvaging some of Oracle's technology. That system won't be ready until next year, so Medicaid-eligible residents will also use HealthCare.gov during the new enrollment period.

Deloitte is the "system integrator," the general contractor that oversees the entire transition. The decision to forego a system integrator by Cover Oregon was widely blamed for contributing to the site's failure to launch.

Deloitte will also create a new website - OregonHealthCare.gov - that won't enroll people, but will redirect Oregonians to HealthCare.gov. The transition to HealthCare.gov has been glitch-free so far.

"Overall the project is on track, it's going well," said Tina Edlund, the state administrator in charge of overseeing the transition.

Oregon's 15 insurance carriers have already uploaded their plan information, cost-sharing information, and premium data to HealthCare.gov, Edlund said. The carriers are currently undergoing end-to-end testing; none have reported experiencing any problems. The federal government also has updated HealthCare.gov to include language specific to Oregon.

Residents' individual data isn't being transferred to HealthCare.gov for reasons of privacy and security, Edlund said. That's why all residents who previously enrolled in private insurance via Cover Oregon will have to reapply via HealthCare.gov.

There will be plenty of support for those applying for or changing insurance plans. Oregonians will now have access to two call centers. The federal call center will help them with enrollment issues. The state's call center will assist with general questions, shopping for plans, or access to community partners, navigators, and insurance brokers.

Agents who want to sell insurance via the federal exchange have undergone training, officials said. Oregon is also currently training community partners and navigators on how to use the federal portal. The Oregon Health Authority has issued $1 million in grants to these partner organizations to continue helping residents.

Officials said applying through HealthCare.gov will be much easier than through Cover Oregon, because people can apply online, in one sitting.

Edlund said she has not heard of any current issues with the federal portal, which experienced major technical problems when it first launched. Earlier this month, the Obama administration unveiled a revamped version of HealthCare.gov featuring a simpler application and a site optimized for mobile devices.

A total of 36 states are currently using HealthCare.gov, and Oregon and Nevada will join them shortly.

While the HealthCare.gov technology should work better, experts say the up to 7 million returning customers across the United States may face complications as they try to renew or change plans.

They will also have to file forms with their 2014 tax returns to prove they got the right subsidy amount. And those who remained uninsured will face a tax penalty unless they can secure an exemption.

Oregon officials have been reaching out to the residents to inform them about the changes and deadlines, said Cover Oregon executive director Aaron Patnode. He said the state plans to spend $1.5 million on television, radio and online advertising that will direct residents to HealthCare.gov, starting after the election.

About 416,000 residents enrolled in coverage through Cover Oregon in 2014. An estimated 105,000 of those enrolled in private health plans, while 311,000 enrolled in the Oregon Health Plan, Oregon's version of Medicaid.

There are no estimates as to how many Oregonians could enroll in 2015. But a study released in September showed 95 percent of the state population now has coverage and about 202,000 Oregonians remain uninsured.

In the meantime, a grand jury is investigating Cover Oregon, as is the federal Government Accountability Office and the inspector general of the U.S. Department of Health and Human Services. The state and Oracle Corp., the main technology contractor responsible for developing the exchange, are suing each other.

The state paid Oracle about $240 million in federal funds to develop the exchange portal and related work.

 

Oregon Dumps Failed Health Insurance Exchange

 

Oregon's troubled health insurance exchange votes to close down state website and send customers to the federal HealthCare.gov website.

 

The HealthCare.gov was an embarrassment at launch, back in October, when many of those seeking insurance found it impossible to create an account and start searching for a plan, let alone sign up for insurance. Yet thanks to an intense turnaround effort, it began to perform respectably by early 2014. At the March 31 deadline for open enrollment -- the date when, despite all extensions, you were at least supposed to start your application -- the site suffered some slowdowns, but at least they were associated with high traffic and a rush of people wanting to sign up. In the following weeks, President Obama was able to announce that signups had topped a goal that previously seemed unreachable -- 7 million -- and then 8 million as more half-finished enrollments were completed.

Still, HealthCare.gov was hardly a success story, and its misadventures ultimately led to the resignation of Kathleen Sebelius as Secretary of the U.S. Department of Health and Human Services.

According to a Kaiser Health News report, New Mexico and Idaho, two states that relied on HealthCare.gov this year, are planning to have their own state exchanges operational by November 2014. With the addition of Oregon, HealthCare.gov would wind up managing enrollment for 35 states for the 2015 open enrollment period, down from 36 this year.

There is even a possibility that HealthCare.gov could pick up additional business from states such as Massachusetts and Maryland, both of which have struggled with underperforming insurance exchange websites. Maryland plans to spend about $45 million to purchase Connecticut's technology, built by Deloitte LLP, but that's partly contingent on securing federal funding for the change.

Download Healthcare IT in the Obamacare Era, the InformationWeek Healthcare digital issue on the impact of new laws and regulations. Modern technology created the opportunity to restructure the healthcare industry around accountable care organizations, but IT priorities are also being driven by the shift.

David F. Carr oversees InformationWeek's coverage of government and healthcare IT. He previously led coverage of social business and education technologies and continues to contribute in those areas. He is the editor of Social Collaboration for Dummies (Wiley, Oct. 2013)

 

Not so rocky: Oregon’s road to HealthCare.gov

 

By Gosia Wozniacka / The Associated Press

 

PORTLAND — As the start of the second open enrollment period for health insurance under the federal Affordable Care Act nears, Oregon officials say this time the state will avoid an enrollment disaster.

When Oregon launched its insurance exchange portal last October, it turned into a technology fiasco. Cover Oregon was the only exchange in the nation that never fully launched and didn’t let the public enroll in coverage in one sitting.

Instead, residents had to use a time-consuming hybrid paper-online application process to get health insurance. Six top officials connected to the Cover Oregon debacle resigned.

The state abandoned its troubled exchange in April after determining it was cheaper to switch to the federal site than to fix Cover Oregon. Officials say they’ve taken steps to ensure a smooth new enrollment period, which starts Nov. 15.

This summer, Oregon hired a tech firm, Deloitte Consulting LLC, to help transition Oregon to the federal exchange and to finish building the state’s Medicaid system.

And earlier this month, officials cut all remaining ties with the state’s main technology contractor Oracle Corp. and decided to use another state’s Medicaid enrollment system instead of salvaging some of Oracle’s technology. That system won’t be ready until next year, so Medicaid-eligible residents will also use HealthCare.gov during the new enrollment period.

Deloitte is the “system integrator,” the general contractor that oversees the entire transition. The decision to forego a system integrator by Cover Oregon was widely blamed for contributing to the site’s failure to launch.

Deloitte will also create a new website — OregonHealth Care.gov — that won’t enroll people but will redirect Oregonians to HealthCare.gov. The transition to HealthCare.gov has been glitch-free so far.

“Overall the project is on track; it’s going well,” said Tina Edlund, the state administrator in charge of overseeing the transition.

Oregon’s 15 insurance carriers have already uploaded their plan information, cost-sharing information, and premium data to HealthCare.gov, Edlund said. The carriers are undergoing end-to-end testing; none have reported experiencing any problems. The federal government also has updated HealthCare.gov to include language specific to Oregon.

Residents’ individual data isn’t being transferred to HealthCare.gov for reasons of privacy and security, Edlund said. That’s why all residents who previously enrolled in private insurance via Cover Oregon will have to reapply via HealthCare.gov.

There will be plenty of support for those applying for or changing insurance plans. Oregonians will now have access to two call centers. The federal call center will help them with enrollment issues. The state’s call center will assist with general questions, shopping for plans, or access to community partners, navigators and insurance brokers.

Agents who want to sell insurance via the federal exchange have undergone training, officials said. Oregon is also training community partners and navigators on how to use the federal portal. The Oregon Health Authority has issued $1 million in grants to these partner organizations to continue helping residents.

Officials said applying through HealthCare.gov will be much easier than through Cover Oregon, because people can apply online, in one sitting.

Edlund said she has not heard of any current issues with the federal portal, which experienced major technical problems when it first launched. Earlier this month, the Obama administration unveiled a revamped version of HealthCare.gov featuring a simpler application and a site optimized for mobile devices.

A total of 36 states are currently using HealthCare.gov, and Oregon and Nevada will join them shortly.

About 416,000 residents enrolled in coverage through Cover Oregon in 2014. An estimated 105,000 of those enrolled in private health plans, while 311,000 enrolled in the Oregon Health Plan, Oregon’s version of Medicaid.

 

Below are common questions and answers about applying for and enrolling in health insurance for 2014 and 2015.

Open enrollment for 2014 has ended, but you can still apply to find out if you are eligible for the Oregon Health Plan, Healthy Kids or a special enrollment period for private health insurance in 2014. Apply now for a 2014 health plan.

Open enrollment for 2015 begins November 15, 2014. Starting November 15, come back to CoverOregon.com to answer a few simple questions to find out which application is best for you. We’ll guide you to HealthCare.gov for private health insurance or to OregonHealthCare.gov for the Oregon Health Plan/Healthy Kids (Medicaid/CHIP coverage).  

 


Getting health insurance for 2015

What are the dates for 2015 open enrollment?

The open enrollment period for 2015 coverage is November 15, 2014 to February 15, 2015. If you choose a plan by December 15, your coverage can start as early as January 1, 2015. Note: If you qualify for the Oregon Health Plan or Healthy Kids, you can apply and enroll any time of year. 

Where can I apply for health insurance for 2015?

Starting November 15, Cover Oregon will guide you to the application that’s right for you. After answering a few questions, you will be routed to the application for private health insurance or to the application for the Oregon Health Plan/Healthy Kids.

  • If you qualify for a private health plan, you will be able to shop for plans and enroll right away at HealthCare.gov. You may also qualify for financial savings to lower your costs.
  • If you qualify for free or low-cost coverage through the Oregon Health Plan or Healthy Kids, you will be automatically enrolled in a plan after applying.

 

I enrolled in a 2014 private health plan through Cover Oregon. How do I renew (continue) my plan for 2015?

If your current private health plan is still available for 2015, you can renew it through HealthCare.gov starting November 15, 2014. At HealthCare.gov, you will also be able to find out if you’re eligible for financial savings to lower the cost of your 2015 coverage. If your current plan is not available for 2015, you will be able to choose a new plan.

I am enrolled in the Oregon Health Plan (OHP) or Healthy Kids. How do I renew (continue) my plan for 2015? What if I already renewed?

When it is time for you to renew your OHP or Healthy Kids plan, the Oregon Health Authority (OHA) will send you a letter with information about how to renew. If you just recently renewed, you won’t need to do anything more until you receive the next renewal letter from OHA next year.

Will I still be able to apply for the Oregon Health Plan, Healthy Kids and/or private health insurance through Cover Oregon for 2015?

Yes, CoverOregon.com will continue to serve as a source of information and as a guide to help you find the health coverage that’s right for you.

I am a small business owner. Can I purchase group health insurance for my employees through Cover Oregon?

At this time, you cannot purchase group coverage through Cover Oregon. However, you can purchase a Cover Oregon-certified health insurance plan directly from a participating insurance company. Purchasing a Cover Oregon-certified plan is the only way to take advantage of the IRS Small Business Health Care Tax Credit in 2014 and 2015.


Health coverage for 2014: application and enrollment

I need health insurance now (in 2014). Can I still apply?

Yes, you can still submit an application for 2014 health coverage even though open enrollment for 2014 has ended.Apply now or schedule an appointment with a certified insurance agent or community partner to get with your application.

  • If you are eligible for the Oregon Health Plan or Healthy Kids, you will be enrolled automatically.
  • If you are eligible for a private plan, you will only be able to enroll in a plan if you or another household member has had a qualifying event, such as getting married or adding a family member. If you haven’t had a qualifying event, you can apply for and enroll in a 2015 plan during the next open enrollment period, which starts November 15, 2014.

 

I applied through Cover Oregon in 2014 but never enrolled in a plan. Can I still enroll?

If your enrollment deadline has not passed, you can still enroll in a 2014 private health plan through Cover Oregon. If your enrollment deadline has passed but you have recently experienced a qualifying event, you may still be able to enroll. If you are eligible for the Oregon Health Plan/Healthy Kids, you will be automatically enrolled in a plan. Call us at 1-855-CoverOR (1-855-268-3767) if you’re not sure.

Remember: you can apply for and enroll in a 2015 health plan during the next open enrollment period, which starts November 15, 2014.

 

I am enrolled in a 2014 private health plan through Cover Oregon. Do I need to do anything now to enroll in a 2015 plan?

If you are currently enrolled in a private plan through Cover Oregon, you will need to re-enroll in your plan through HealthCare.gov – you can re-enroll as early as November 15, 2014. Watch your mail or sign up for email updates for more information about how to maintain your coverage through 2015.

I purchased an individual/family private health plan through Cover Oregon in 2014. When will my 2014 plan end?

All individual/family private health plans purchased through Cover Oregon in 2014 will end on December 31, 2014. If you’d like to continue your private health insurance for 2015, visit HealthCare.gov starting November 15, 2014 to re-enroll. If you enroll by December 15, 2014, your coverage can start as early as January 1, 2015.

I received a missing information letter. What is the deadline for providing missing information?

We are unable to process applications if there is missing information. If you received a missing information letter, the deadline for providing the information should be listed in your letter. If you have questions about your specific date or want to provide your information today, please call us at 1-855-CoverOR (1-855-268-3767).


Life changes and qualifying events
 

What are life changes?

Some of the life changes you should report are: marriage, divorce and changes in family size, income and/or address. Life changes can affect your eligibility for health insurance and financial assistance. Learn more about all of the life changes you should tell us about. If your life change is also a qualifying event, you may be able to enroll in or change private plans even though open enrollment has ended. Life changes should be reported within 60 days of the change.

How do I report changes?

Whether you’re enrolled in the Oregon Health Plan/Healthy Kids or a private health plan through Cover Oregon, you should call us at 1-855-CoverOR (1-855-268-3767) to report changes. Please call within 60 days of the change or as soon as possible. It’s important to report all changes to Cover Oregon, rather than to your insurance company or to the Oregon Health Authority.

I haven’t applied for coverage, but I have had a qualifying event. Can I apply even though open enrollment for 2014 already ended?

Yes, you can apply. If you have had a qualifying event, you may be able to enroll in a private plan for 2014. If you’re eligible for the Oregon Health Plan or Healthy Kids, you will be automatically enrolled in a plan.


Cancellations
 

How do I cancel my private insurance?

If you need to cancel the private health plan you purchased through Cover Oregon, please call 1-855-CoverOR (1-855-268-3767). Keep in mind that you may be subject to a federal tax penalty if you do not have health insurance for more than three months.


Federal Tax Penalty

How can I make sure I don’t have to pay the federal tax penalty (also called a shared responsibility payment)?

Oregonians who applied by April 30, 2014, and enrolled in a plan through Cover Oregon may not be subject to the federal tax penalty. If you purchased health insurance any time after April 30, however, you may be at risk for having to pay a penalty.

The IRS determines who has to pay the tax penalty and who is exempt from it. Cover Oregon does not assess the penalty. Learn more about exemptions and how the penalty is assessed.

How much is the federal tax penalty for not having health insurance? 

The federal tax penalty for not having health insurance in 2014 is the greater of 1 percent of your household income or $95 per adult/$47.50 per child (family maximum of $285). The penalty is based on the number of months uninsured and is prorated. The penalty will increase every year, and by 2016, it will be $695/per adult or 2.5 percent of income.

Are there any exemptions from the penalty?

Yes, some people may be exempt from the penalty. You can learn more about exemptions and how to claim them at CoverOregon.com or at irs.gov.


 


General

What’s the future of Cover Oregon?

As we move into 2015, Cover Oregon will continue to be a source of information for you and will serve as a guide to help you find the coverage that’s right for you for 2015.

 

Glossary of terms

Actual Rates

Actual rates are developed and presented to individuals or group applicants after they have provided specific demographic information.

Adjustment Type

Adjustments are deducted from income on Federal tax returns in order to arrive at your Modified Adjusted Gross Income (MAGI).

Advance payment of premium tax credit (APTC)

If a person qualifies for advance payment of premium tax credits (APTC), the amount will be applied right away and sent directly to the insurance company each month to reduce the premium. See also "APTC."

Affordable Care Act (ACA)

The Affordable Care Act (ACA) is the health care reform law enacted in March 2010 that mandates all Americans have health insurance coverage. It puts individuals, families, small businesses and Tribal organizations in control of selecting and managing their insurance coverage. It also provides other reforms, including guaranteed coverage regardless of an individual’s health status.

Agent

Agents affiliated with Cover Oregon are licensed health insurance agents who have also completed the Cover Oregon training and certification program. They help individuals and small employers by guiding them through the complexities of purchasing and enrolling in health insurance coverage to get the best price based on specific situations and needs. Agents also act as advisors when clients need help navigating claims processing after they incur services. Agents are paid a commission for their work, which does not increase the cost of insurance coverage.

Allowed Amount

Allowed amount, also known as 'eligible expense,' 'payment allowance' or 'negotiated rate,'' is the maximum amount a carrier will pay for covered health care services. If services cost more than the allowed amount, the insured individual may have to pay the difference.

Annual Income

Annual income is the total amount an individual received via wages, salary and various investments throughout a calendar year.

Annual Maximum

Annual maximum, or 'annual max,' is the total dollar amount that an insurer will pay toward services in a coverage year. Once the annual maximum is reached, the insurer will not cover additional services until the beginning of the next plan year.

Appeal

An appeal is a request to review a decision.

APTC

APTC refers to advance payment of premium tax credits. If a person qualifies for APTC, the amount will be applied right away and sent directly to the insurance company each month to reduce the premium. See also "Advance payment of premium tax credit."

Assister

Assisters are staff members or volunteers at community partner organizations who are trained and certified to help educate individuals and families about health coverage plans and assist them with the Cover Oregon application and enrollment processes. Assisters include application counselors, consumer assisters, in-person assisters, navigators and non-navigators as defined by the Department of Health and Human Services.

Authorized Representative

An authorized representative is a person, such as a guardian or an individual who has power of attorney, who is authorized to help make decisions for others. These decisions include enrolling in a health coverage plan or handling claims and payments. An authorized representative may sign the application on behalf of the enrollee.

Balance Billing

Balance billing occurs when a provider bills the insured individual for the difference between the provider’s charge and the allowed amount. A preferred provider may not balance bill for covered services.

Benefits

Benefits refer to any available services under health coverage.

Calendar Year

Calendar year is the period from January 1 through December 31 of the same year.

Carrier

A carrier is a licensed company that provides health and/or dental insurance coverage for individuals, families and groups. A carrier may also be referred to as an 'insurer' or 'insurance company.'

Catastrophic Plan

As defined in the Affordable Care Act (ACA), a catastrophic plan will provide individuals with coverage for essential health benefits only after they have paid for cost sharing equal to maximum out-of-pocket limits. Catastrophic plans are available to individuals who are under the age of 30 prior to the start of the plan year, or who have received an exemption from the individual mandate because they do not have an affordable coverage option or because they qualify for a hardship exemption. In 2014, the annual maximum out of pocket cost will be $6,350 for self-only coverage and $12,700 for family coverage.

Census

See: 'Employee census.'

Change In Circumstance

A change in circumstance allows individuals, families and employees to change their health coverage enrollment outside of the open enrollment period because of a qualifying event such as marriage, childbirth, adoption, legal separation, death or loss of employment, among others. Also see: 'qualifying event.'

Children's Health Insurance Program (CHIP)

The Children’s Health Insurance Program (CHIP) provides health coverage for children whose families can’t afford private insurance. CHIP is administered by each state and jointly funded by the federal and state governments. In Oregon, the program operates under the name “Healthy Kids.” Also see: 'Healthy Kids.'

COBRA

CCOBRA is a type of continuation coverage that allows employees and their families to temporarily continue their health coverage offered through an employer, even if they have changed or lost a job, or experienced a change in their eligibility status. Also see: 'continuation coverage.'

Coinsurance

Coinsurance is the insured individual’s share of costs for a covered health care service. This is calculated as a percentage (e.g., 20 percent) of the allowed amount for the service before or after the deductible is met. The insurer pays the rest of the allowed amount.

Community Partner

Community partner organizations are provider clinics, local governments, non-profits and community-based groups that conduct outreach and/or enrollment assistance on behalf of Cover Oregon. This assistance is provided at no cost to individuals and families.

Continuation Coverage

Continuation coverage allows individuals to temporarily continue their health coverage offered through an employer, even if they have changed or lost a job, or experienced a change in their eligibility status. Companies with 20 or more employees are subject to COBRA Continuation. Companies with fewer than 20 employees are subject to State Continuation.

Coordinated Care Organization

A coordinated care organization (CCO) is a network of all types of health care providers (physical health care, addiction and mental health care and sometimes dental care providers) who have agreed to work together in their local communities to serve people who receive health care coverage under the Oregon Health Plan (Medicaid).

Copayment (Copay)

A copayment, also called “copay,” is the fixed dollar amount (e.g., $15) an insured person pays for a covered health care service. Copayment amounts can change depending on the type of service received.

Cost Sharing

Cost sharing refers to any expense paid by an individual for essential health benefits such as deductibles, copayments and coinsurance. These costs are above and beyond the amount the individual pays for a premium.

Cost-Sharing Reduction

Cost-sharing reductions lower the maximum out-of-pocket limits, and they reduce Silver plan deductibles, co-pays and coinsurance amounts for certain qualified applicants.

Coverage Year

The coverage year is the calendar year in which a health coverage plan is effective (e.g., the period from January 1 through December 31 of the same year.)

 

March 26th, 2014

Governor Kitzhaber Announces Cover Oregon Extended Application Period, New Tax Credit Options for Small Businesses

Oregonians have until April 30 to apply for private health insurance

 

(Salem, OR) — Governor Kitzhaber announced today that Oregonians now have until April 30, 2014, to apply for private health insurance. The announcement came following conversations between the Governor and Health & Human Services (HHS) Secretary Kathleen Sebelius. Oregon’s extended application period is in response to technology issues that lengthened the time it takes to apply for and enroll in health insurance through Cover Oregon, the state's health insurance exchange. 

“I know that for too many Oregonians, the Cover Oregon website and its ongoing technical problems have created delays, confusion, and frustration,” said Governor Kitzhaber. “I worked with Secretary Sebelius to give Oregonians more opportunity to secure health care coverage and get the financial help they deserve.” 

Under HHS guidelines, each state may have its own approach to managing extended application periods. Oregon’s extended application period is targeted to people purchasing private health insurance coverage either through Cover Oregon or directly from an insurance carrier. People who purchase through Cover Oregon can access tax credits and other financial assistance. Oregonians who are eligible for the Oregon Health Plan or Healthy Kids can apply for coverage year round. Governor Kitzhaber said, “Cover Oregon has successfully completed more than 175,000 enrollments for Oregonians across our state. I want to make sure that people know they can still apply. They have time to do so, for themselves and their families, and they should take advantage right away.” Oregonians have until April 30 to submit their application for private coverage.

Oregonians can find an agent or community partner in their area who can help them enroll in one sitting by visiting CoverOregon.com. They can also go to CoverOregon.com to find resources to apply, including an online PDF application they can submit electronically. Those who apply for coverage from a private plan through Cover Oregon before April 30 and then later enroll will not be subject to a potential federal tax penalty. People who apply and enroll in plans outside of Cover Oregon between April 1 and April 30 may have to pay a partial federal penalty. The Oregon Insurance Division will provide more information about how penalties may apply to individuals who do not apply for coverage through Cover Oregon. Answers to questions about the extended application period can be found here

Help With Tax Credits for Small Businesses

The Governor also announced an agreement between Cover Oregon and participating insurance companies that will help small businesses access federal tax credits. Qualified small businesses that purchase a Cover Oregon-certified plan after April 1 directly from an insurance company will be able to access tax credits for 2014. “This is an important step forward to support small businesses and get health insurance coverage for more people,” said Governor Kitzhaber. 

For the small business tax credit, Cover Oregon will provide an eligibility notice to Oregon employers that qualify to participate. Eligible businesses must have 50 or fewer full-time equivalent employees; purchase a “qualified health plan” certified by Cover Oregon; and contribute at least 50 percent of the premium cost for employee coverage. With confirmed eligibility, employers can apply for the Small Business Health Care Tax Credit when filing their 2014 taxes. The Internal Revenue Service, not Cover Oregon, determines eligibility for the tax credit. Cover Oregon developed the new process for facilitating the employer tax credit in cooperation with Atrio, Health Republic, Kaiser Permanente, Moda, Oregon’s Health Co-op, PacificSource, Providence, Trillium, Best Life, Dental Health Services, Guardian, and ODS. “Insurance companies have provided us a great deal of flexibility to serve Oregon small businesses,” said the Governor. 

Oregonians with questions about how to apply can visit CoverOregon.com or call 1-855-CoverOR. The Cover Oregon service center is open Monday-Friday from 8am to 8pm, and Saturday-Sunday from 8am-6pm. Additional information on small business tax credit may be found here