‘Tis the season Consumers can start browsing Obamacare plans in advance of purchase

Consumers can now go online to HealthCare.gov and start “window shopping” for the health insurance plans they’ll be able to buy beginning Saturday, when open enrollment kicks off for the second year of Obamacare.New Jerseyans who visit HealthCare.gov this week can compare health plans from five insurance companies, up from the three insurers who competed for customers on the exchange in 2014.

UnitedHealthare and Oscar Insurance are entering New Jersey’s HealthCare.gov market this year, joining the three existing insurers: Horizon Blue Cross Blue Shield of New Jersey, AmeriHealth New Jersey and Health Republic Insurance of New Jersey.

For 2014, about 160,000 New Jerseyans bought coverage on HealthCare.gov, and more than 80 percent qualified for federal subsidies to make that coverage more affordable. The subsidies are on a sliding scale based on income, up to four times the federal poverty level, or about $46,600 for an individual and $95,400 for a family of four.

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The HealthCare.gov window shopping feature asks consumers to plug in information, including their ZIP code and age, income and dependents, then generates a menu of health plans and prices. For example, a Morris County family of three (two adults age 35 and a 5-year-old) with family income of $55,000 a year generated a menu of 47 choices. Those 47 health plans range from $336 a month for a “bronze” plan with a $5,000 a year deductible, to $1,040 a month for a platinum plan with a zero deductible. The window shopping tool provides detailed information about each plan, including information about co-pays and prescription drugs, as well as the doctor and hospital network.

Open enrollment on HealthCare.gov runs from Nov. 15 to Feb. 15, 2015, for coverage that takes effect in 2015.

Insurance broker David Oscar of Altigro said window shopping is a good feature because consumers “can see what is really out there and be prepared before they purchase a plan.” He said that, in 2014, some consumers made the mistake of choosing the plan with the lowest premium, then found they had high out-of-pocket expenses because the low-premium option also came with high co-pays and deductibles.

Oscar said that, before choosing a plan, consumers should “think about how they used their health plan in the last year. What were their expenses over the last year and do they think they will have the same expenses going forward?”

He said consumers need to look at all the plan’s expenses — not just the premium, but the out-of-pocket costs when the health benefits are actually used. If the shopper just buys a plan based on the premium, “You might end up with a health plan that isn’t going to serve your needs.”

John Sarno, president of the Employers Association of New Jersey, said this week’s window shopping in advance of the start of open enrollment on Saturday “is a nice innovation” from the federal Department of Health and Human Services, which operates HealthCare.gov.

Sarno said he went through a test run of the window shopping feature, and he found that while premiums are similar to 2014, they are likely to be higher in 2015 than 2014, depending on the plan the consumer chooses.

This will create an issue for individuals buying health insurance, because “Wages have not gone up,” Sarno said. “Wages have not kept up with health care inflation.”

Ryan Petrizzi, vice president of consumer markets and sales operations for AmeriHealth New Jersey, said the company had received approval for an overall 11.5 percent increase in its rates. He said the increases vary by plan, and that about 5.5 percent of that increase represents health insurance taxes and fees.

Health Republic Insurance Co. of New Jersey said the company has reduced its premiums between 10 and 20 percent, depending on the plan, for 2015 compared to 2014. The company had said its premiums were generally higher than the competition in 2014, and cited that as a reason HRINJ came in third in enrollment this year, after Horizon and AmeriHealth.

“Having listened to our members over the past year, we’ve designed plans that offer some exciting features and attractive pricing,” said Jim Martin, CEO of HRINJ. “New members will find choices that resonate with their lifestyle and family needs, and value-added benefits that will make it a much more fruitful shopping experience.”

Meantime, EANJ is among the “navigators” helping the uninsured in New Jersey to sign up for health coverage; EANJ is working with employers to encourage them to help their workers get coverage at HealthCare.gov.

Sarno said the website EANJ launched to spread the word, Get Workers Covered.org, is getting traction. Sarno said in the first two weeks the website has reached about 14,000 workers through about 6,000 employers. He said he has held four meetings with employers so far. Three more regional meetings have been scheduled with employers in Middlesex, Monmouth and Ocean counties through the remainder of the year, and he said there will be another 10 smaller meetings before chambers of commerce and business groups.

Ray Castro, senior policy analyst for New Jersey Policy Perspective, said: “It looks like there is a significant increase in the number of plans (available this year). Options are usually a good thing, but sometimes there are so many options that they’re difficult to understand. It will probably be helpful for consumers to use navigators and brokers to help guide them.”

Castro said some of the plans have changed so he was not able to compare premium rate changes.

Maura Collinsgru of New Jersey Citizen Action said window shopping is a good idea: “Generally, any preplanning/previewing consumers can do would be helpful.” 

She said consumers should consider the amount of the potential subsidy they might receive, and make sure they find out, “Does the plan cover the prescriptions they may need; is the doctor they use (or want to use) included in the plan’s network?”

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