Some reform applications will not be available to area residents Oct. 1

Regarding the Oct. 1 start of open enrollment in the Health Insurance Marketplace and Medicaid expansion under the Affordable Care Act (ACA, also known as health care reform), the state of Illinois is now providing further details about the launch of the its Health Insurance Marketplace, “Get Covered Illinois” and the new online Medicaid enrollment platform (ABE). Some of the system applications will not be immediately available on Oct. 1. Here is a summary of the latest developments.

“Get Covered Illinois”

On Sept. 25, 2013, the state of Illinois unveiled “Get Covered Illinois” as the official brand name for its new health insurance marketplace, where residents will be able to find quality coverage as mandated by the ACA. The name is both a call-to-action and a description of the service this marketplace expects to provide through web, phone and personal interactions with customers after Oct. 1. The brand tagline for Get Covered Illinois is “The Official Health Marketplace.”

Each of the 13 rating areas in Illinois will have at least three insurers offering a minimum of 29 individual policies and 28 small group policies. The maximum number of plans will be offered in Cook, Lake and McHenry counties where up to 66 individual plans and 39 small group plans will be offered. Most consumers will have access to Bronze, Silver and Gold plans, but Platinum plans will not be available in all counties. Benefits are the same for all plans, but the premium and cost-sharing amounts vary, depending upon the “metal” tier. For example, the Bronze plan has a lower premium but higher out-of-pocket expenses; Platinum plans require higher premiums, but lower out-of-pocket costs.

The average monthly premium cost of the second lowest cost Silver plan (plans on which subsidy calculations will be based) is projected to be $264 in Chicago and $312 in Peoria. It is estimated that a 30-year-old non-smoking consumer could pay as little as $69 per month for premium in Chicago for the lowest cost Bronze plan when the subsidy is taken into account.

The state still has not released the address (URL) of the website that will act as the landing page for marketplace and newly Medicaid eligible enrollees but anticipates the page will be available soon for open enrollment. The release date for the Get Covered Illinois toll-free phone bank is still in question as well. The state will engage in a “modest” October outreach roll out, with the major multimedia outreach designed to get the majority of eligible individuals enrolled by Dec. 15, 2013, the last day consumers can enroll in order to have coverage effective on Jan. 1, 2014.

To coordinate the outreach effort, the state is dividing Illinois into 10 regions designed to maximize contact with the uninsured population. The state has hired coordinators for eight of the 10 regions. It is also anticipated that the state will train more than 1,200 in-person counselors to perform outreach across Illinois. An in-person counselor for McHenry County is being hired by Centegra Health System. The public will be notified once that counselor’s hours are available.