- Associated Press - Sunday, November 2, 2014

WHAT IS 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. Unlike people in other states that rely on the federal portal, Oregon residents with existing Cover Oregon plans will not be automatically re-enrolled in their old plan if they do nothing.

People already enrolled in Medicaid need not do anything, until the state sends them a renewal letter.

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% 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 (OHP), 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.

Next year, Oregon plans to build a new Medicaid portal - using the technology of another state’s Medicaid enrollment site - but that portal won’t be available during the coming open enrollment period.

IF YOU’RE A SMALL-BUSINESS OWNER: 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 DOES COVERAGE START: For those who qualify for Medicaid, coverage starts immediately. For those who enroll in private insurance between the 1st 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 December 15 will have coverage starting as early as January 1, 2015.

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% 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.

BOTTOM LINE, WHAT WEBSITE TO USE: Most residents should use HealthCare.Gov. CoverOregon.com will continue to serve 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

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