The federal marketplace for purchasing health insurance is turning one year old this month and the enrollment period for buying a plan, or changing it, is now open. Buyers of individual health care plans can expect to pay more, according to the state’s insurance regulator. A preferred provider plan for Blue Cross Blue Shield is expected to rise 18 percent and a PPO for Cigna Health is set to go up by 17 percent, on average. There will also be a third insurance company available to Monroe County residents — Assurant Health Insurance.

“I just learned about the new insurance,” said Stacey Dumas, owner of Benefit Solutions of Florida. “I haven’t looked at the plan very closely, but Keys residents will now have a third option.”

According to an Associated Press/Health News Florida article, of the 11 insurers that were on the exchange last year, rates will increase for eight of the insurers (11 to 23 percent) and decrease for three of the insurers (-5 to -12 percent).

Florida residents have until Dec. 15 to enroll in a plan with coverage beginning on Jan. 1.
The penalty for not having insurance has also increased. This year, uninsured Americans paid 1 percent of income or a $95 fee, whichever was higher. In 2015, Americans must pay 2 percent of household income or a $325 fine per person ($162.50 for children under 18), whichever is higher.

Dumas said she helped about 72 families enroll in the federal insurance marketplace last year.

“A lot of the people qualified for subsidies. They were mostly employed in the service industry — waitresses, manicurists and fishermen,” Dumas said. “The other segment of the population who needed help were the early retirees. They are too young for Medicare but no longer qualify for group health insurance through their employers.”

This will be the year the Affordable Care Act’s employer mandate is instituted. In 2015, large business with more than 100 employees will be required to offer affordable health plans to employees or pay a fine to the federal government. In 2016, it will be required of companies with 50 or more employees. There are few Keys businesses that will be affected by this rule, as most employers in the Keys are much smaller.

According to CEO Hal Leftwich, Fishermen’s Community Hospital with 209 full- and part-time employees, has no plans to change coverage for its workers.

“We will maintain the same insurance as last year. We were able to negotiate a fairly good rate and lower the cost to our employees,” said Leftwich, adding that the provision runs through June. “I expect it will go up some then.”

The City of Marathon, with just over 50 employees, has seen a 5.9 percent increase in health insurance premiums this year, since the policy took affect on Oct. 1.

It’s interesting to watch health care reform evolve,” Dumas said. “Because some people have really been helped, they have great stories, and other people are really getting hurt.”

Editor Sara Matthis thinks community journalism is important, but not serious; likes small and weird children (she has two); prefers target practice with a zombie rat poster; and looks best with saltwater dreads. Occasionally she tortures herself with sprint-distance triathlons, but only if she has a good chance of beating her sister.

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