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Ohio health insurer to offer plans in 32 WV counties

CHARLESTON, W.Va. — Some West Virginians will have new options for plans on the state’s health insurance marketplace next year.

Dayton, Ohio-based CareSource, which originally offered plans in 10 West Virginia counties, will expand to 22 more counties next year, a company official said.

“We had intentions of growing our footprint in WV when we launched CareSource coverage in 2015,” Michael Ross, the company’s manager for the West Virginia marketplace, said through a spokeswoman. “We expanded this year, because we know consumers want more options and we believe in the benefits of our coverage.”

CareSource originally offered plans in Brooke, Cabell, Hancock, Kanawha, Lincoln, Marshall, Mason, Ohio, Putnam and Wayne counties. Next year it will add plans in: Barbour, Boone, Calhoun, Clay, Doddridge, Fayette, Gilmer, Harrison, Jackson, Logan, Marion, Monongalia, Pleasants, Preston, Raleigh, Ritchie, Roane, Taylor, Tyler, Wetzel, Wirt and Wood counties.

The open enrollment period for the Health Insurance Marketplace will be Nov. 1 through Jan. 31, 2017. West Virginia’s marketplace, setup under the Affordable Care Act, is a joint partnership between the state and the federal government. West Virginians who don’t get insurance through an employers may purchase insurance there. Two companies — Highmark Blue Cross Blue Shield and CareSource — offer plans on the exchange.

Rates for plans from both companies will increase this year, but subsidies from the federal government will increase to offset the increases, said Jeremy Smith, an outreach coordinator with WV NaviCare, a project funded by a federal grant and operated by First Choice Services.

Last year, 86 percent of West Virginians who bought insurance on the exchange were eligible for subsidies, Smith said.

Ross said the CareSource’s rates in West Virginia will increase “into the 35 and 40 percent margins.”

“We are offering two new lower Silver Premium plans,” Ross continued. “In addition, consumers will not feel the total increase because of tax credits. The tax credits allow for subsidies that will help to absorb the cost of the premium increase based on income.

“Health Insurance Premiums from a non-profit plan are a direct reflection of the cost of health care, health systems costs and pharmaceuticals. At CareSource, our commitment is still to offer consumers the most affordable coverage for themselves and their families continues.”

Highmark Blue Cross Blue Shield has proposed an average rate increase of 31.82 percent, according to health insurance guide website healthinsurance.org.

Cathy McAlister, a spokeswoman for Highmark, said the company remains committed to the Affordable Care Act and will continue to offer plans in all 55 counties in West Virginia. She did not say if the company would increase rates or what they might be.

 “The West Virginia Offices of the Insurance Commissioner plans to release information and rates toward the end of October — so, in the next few weeks,” she said in an email. “We will be happy to discuss our options in more detail at that time, but for now, this is all the information we have.”

With plans qualified through the Affordable Care Act, people won’t pay more than 10 percent of their income for basic health insurance, said Joel Thompson, a Ceredo-based insurance broker.

“With an ACA-qualified health plan, individuals will never have to pay more than about $7,000 a year for medical services, plus their plan premiums,” Thompson said. “In addition, if more than one family member is sick, the most they’ll have to pay for the entire family unit is a little more than $14,000 in a year.”

Smith encouraged people to consider all of their options before picking a plan.

“A lot of plans are changing we really are encouraging people to shop and look at all the different options that are available to them this year,” Smith said.

Smith also said people should be careful where and from whom they buy their health insurance. People can shop for health insurance on the exchange directly through the federal website healthcare.gov. Those who shop through other websites may end up getting dozens of calls from telemarketers selling plans that don’t meet federal guidelines, Smith said.

“[The plans are] legal but they use a lot of trickery,” he said. “People don’t know what looking they’re for.”

People who buy these plans, called limited benefit plans, still will be required to pay a federal penalty on their income tax because they don’t have insurance that meets federal guidelines, Smith said.

The tax penalty for not having health insurance is $695 or 2.5 percent of a person’s annual income, whichever is more, Smith said. Smith encourages people to read through the fine print on a health insurance plan before signing up for one.

West Virginians can get free help signing up through WV NaviCare by calling its helpline at 1-844-WV-CARES or online at www.wvnavicare.com.

Reach Lori Kersey at [email protected], 304-348-1240 or follow @LoriKerseyWV on Twitter.

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