Marketplace offers second chance

HOUGHTON – For the first time, Americans who went through 2014 without health insurance are taking a hit this tax season, paying a $95 “shared responsibility payment” for each adult in the family not covered. The Health Insurance Marketplace hopes that fee serves as a wake-up call, and is offering a Special Enrollment Period through April 30 to give people who hadn’t understood the penalty one more chance to sign up before it jumps to at least $325 next year.

According to a press release from the Upper Great Lakes Family Health Center in Hancock, to be eligible for the Special Enrollment Period (SEP), individuals and families must have paid the fee on their 2014 taxes, not be currently enrolled through the federal marketplace and not have understood the fee prior to doing their taxes.

“We recognize that this is the first tax filing season where consumers may have to pay a fee or claim an exemption for not having health insurance coverage,” Centers for Medicare and Medical Services Administrator Marilyn Tavenner said in the release. “Our priority is to make sure consumers understand the new requirement to enroll in health coverage and to provide those who were not aware or did not understand the requirement with an opportunity to enroll in affordable coverage this year.”

Iola Brubaker, an outreach and enrollment specialist with Upper Great Lakes Family Health Center, said in an interview those taking advantage of the SEP would have all the same options available as those who signed up during the normal enrollment period. All federal services for signing up are also available, at healthcare.gov or through the 24-hour federal help line at 800-318-2596. The help line can assist those without Internet access or who just need some guidance.

Locally, Brubaker is available to meet for free with anyone in Houghton, Keweenaw, Baraga or Ontonagon counties needing help buying Health Care Marketplace insurance or Healthy Michigan coverage. Brubaker said she’s not keeping office hours in various communities as she did during the regular sign-up period, but she is willing to make the meetings convenient.

“If someone calls, I’ll set up a location,” she said. “I’ll find a location near you.”

Brubaker said the requirement that insurance applicants didn’t understand the tax penalty is handled with a signed statement saying so, but the process can’t be started until tax returns are filed.

For those who don’t sign up, next year’s fee will be $325 per uncovered adult and $162.50 per child, or 2 percent of income above the tax filing threshold, whichever is greater.

People who sign up for insurance now will still probably pay a partial fee on next year’s taxes for the part of the year spent without insurance, Brubaker said. They can apply for an exemption allowing up to 60 days without insurance, but “anything over the exemption period they would have to pay the fine pro-rated,” she said.

Brubaker said Health Insurance Marketplace enrollment is open year-round to people who lose or need insurance due to marriage, divorce, birth, significant income change or other special circumstances involving loss of health care. She said the Healthy Michigan Plan for qualified residents is also open year-round, and the healthcare.gov site will refer people to Healthy Michigan if they qualify.

According to a recent report from the U.S. Department of Health and Human Services, about 16.4 million uninsured people have gained health coverage since the Affordable Care Act passed about five years ago.

To schedule an appointment with Brubaker, call 370-4075 or go to uglhealth.org.