COVER OREGON & OREGON’S LIBRARIES

ARIANE HOLM, COVER OREGON

ROB SASSOR, METROPOLITAN GROUP

NOVEMBER 13, 2013

Cover Oregon is a new health insurance marketplace where Oregonians can choose from different health insurance carriers and plans that fit their needs and budget, and access financial help to pay for coverage.

COVER OREGON

BACKGROUND

• Created in 2011 by Oregon Legislature

• Formed as public corporation

• Key piece of Affordable Care Act

• Custom-built for Oregonians

• Dec. 15: Deadline to enroll in coverage for plan to start Jan. 1, 2014

• Jan. 1, 2014: Coverage for individual plans begins

• March 31, 2014: Open enrollment ends for private plans.

TIMELINE

ACA CHANGES• Can’t be denied for pre-

existing condition

• Essential health benefits

• Financial help

• Medicaid expansion

• Requirement to have insurance

• Health insurance marketplaces (exchanges)

• Carriers must spend 80% of premiums on care

Mental/behavioral health

ESSENTIAL HEALTH BENEFITS

Hospitalizations Ambulatory services

Maternity/newborn care

Emergency services

Prescription drugs

Laboratory services

Rehabilitative/habilitative services & devices

Pediatric vision care

Prevention/wellness

PLANS THROUGH COVER OREGON

PLAN CHOICE

Number of plans in individual market: 102

Number of plans in small group market: 73

Number of HSA-qualified plans: 24

INDIVIDUAL PRIVATE PLAN INSURERS

formerly ODS

PUBLIC MEDICAL PROGRAMS

SMALL EMPLOYER PRIVATE PLAN INSURERS

formerly ODS

DENTAL INSURERS

INDIVIDUALS AND FAMILIES

INDIVIDUALS AND FAMILIES• Financial help

• Clear information and price transparency

• Side-by-side comparisons

• One-stop shopping

• Quality coverage and grades

• Help enrolling

• HSA-eligible plans

ELIGIBILITY FOR FINANCIAL HELP

HOW TO TAKE THE TAX CREDIT

• If you qualify for a tax credit, you can choose to receive it monthly or annually

• Monthly: Choose to take the maximum tax credit each month, or just take part of it

• Advantage: Lower your health care premium each month

• Annually: Choose the minimum monthly tax credit ($0)

• Advantage: Lower the amount you pay--or increase your refund--at tax time

INFORMED DECISIONS ABOUT PREMIUMS VS. COPAYS

HOW TO APPLY

WHERE TO FIND APPLICATION

• Visit home page of CoverOregon.com

• Call 1-855-CoverOR to request an application

• Find a community partner or agent on CoverOregon.com to help you fill out an application

• Go to any Department of Human Services office in the state

HOW TO APPLY

“FAST TRACK” ENROLLMENT

• For families pre-screened as newly eligible for OHP based on SNAP applications or kids enrolled in Healthy Kids

• More than 260,000 Oregonians received letter from OHP/Healthy Kids letting them know they’re eligible

• If you received a notice, you just need to fill out and sign the form and send back

• Once they send back the form, they’ll get coverage starting Jan. 1, 2014!

• More than 70,000 Oregonians have already signed up!

• More info at: http://www.oregon.gov/oha/healthplan/pages/fast-track.aspx

HOW TO CHOOSE A PLAN• Search by:

• Geography

• Price

• Provider

• Quality rating (12 metrics first year)

• Carrier

• Plan type (e.g., HMO, PPO)

• Deductible

• Out-of-pocket maximum

• Metal tier (bronze, silver, gold, platinum)

HOME PAGE

FINDING AGENTS/COMMUNITY PARTNERS

BROWSE PLANS

SMALL BUSINESSES

SMALL BUSINESSES

• Choice

• Clear information

• Set contribution

• Quality coverage

• Streamlined administration

• Access to tax credits

• Premium only Plan Section 125 documents

PROVIDING INFORMATION FOR YOUR COMMUNITY

• Brochures

• Fact sheets

• Posters

• Print materials available in: English

Simplified and Traditional Chinese

Japanese

Korean

Russian

Spanish

Vietnamese

A custom version for tribal members

• Text for social media posts and newsletter articles

AVAILABLE TOOLS

• Order print materials at CoverOregonStore.com

• Download fact sheets and other resources: resources.coveroregon.com/fact-sheets.html

• Download Cover Oregon’s “Toolkit for Community Partners” for social media posts and newsletter: coveroregon.groupsite.com (see “Cover Oregon Branded Materials” in the “File Cabinet”)

HOW TO ACCESS OUR TOOLS

1. Download and order materials, and display them at your library

2. Organize a book display to promote health literacy

3. Include content about Cover Oregon in your e-newsletters, website, social media sites and other communications

4. Set CoverOregon.com as the home screen on public computers

5. Start today and continue sharing information through March 31, 2014 when open enrollment ends

HOW YOU CAN HELP

CONNECT WITH US

Sign up for email alerts at CoverOregon.com

@CoverOregon Facebook.com/CoverOregon

www.LinkedIn.com (search “Cover Oregon”)

www.Plus.Google.com (search “Cover Oregon”)

CoverOregon.com

www.YouTube.com/CoverOregonVideo

CoverOregon.com