Oregon Health Insurance Marketplace
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Portland Benefits Group is an independent insurance agency in Oregon. The ideal one-stop insurance marketplace for Oregonians. We find the best combinations of plans and services from the top insurers for our clients. Founded in 2012, Portland Benefits Group agents have helped thousands of people navigate a confusing insurance system. We’re always here when you need us. You don’t have to sit on hold with an exchange or an insurance company.
Cover Oregon to be Replaced By Healthcare.gov
It is now official that Cover Oregon will be replaced by the Federal Health Insurance Marketplace for next year’s open enrollment, which starts Nov 15th, 2014 and ends Feb 15th, 2015. For the time being, Cover Oregon will still be handling applications, mostly submitted through agents due to technical limitations. For assistance with Special Enrollment Period enrollments, please contact our office and we will go over your eligibility for financial assistance and the cost and coverage of the plans available in your area.
Special Enrollment Periods last for 60 days after any of the events listed below:
1. Change in family status (birth of a child, marriage, etc.)
2. Loss of other health coverage
If you have experienced either of the above situations, we can assist you with enrolling in new coverage, either through the health exchange or directly with the insurer with the best plans and rates for you
Why Use A Marketplace Agent
With the high cost of health insurance these days, finding the right plan is about trying to find a balance between coverage that lets you sleep at night, and premiums that let you eat during the day. Obamacare is confusing, and if you choose the wrong plan, you could be forfeiting thousands of dollars in government assistance, or end up with a plan that doesn’t allow you to see the doctors you want. We can explain all of your options under the law, find a plan that best meets your needs and your budget, and help you through the application process.
Portland Benefits Group offers a complete line of insurance products and services. These products and services are designed to provide solutions to your personal and business financial needs.
- Life Insurance
- Long-Term Care
- Travel Insurance
- Long Term Care
Obama administration prepares to take over Oregon’s broken health insurance exchange
The Obama administration is poised to take over Oregon’s broken health insurance exchange, according to officials familiar with the decision who say that it reflects federal officials’ conclusion that several state-run marketplaces may be too dysfunctional to fix.
In public, the board overseeing Cover Oregon is scheduled to vote Friday whether to join the federal insurance marketplace that sells health plans in most of the country under the Affordable Care Act. Behind the scenes, the officials say, federal and Oregon officials already have agreed that closing down the state marketplace is the best path to rescue what has been the country’s only one to fail so spectacularly that no resident has been able to sign up for coverage online since it opened early last fall.
The collapse of Oregon’s insurance marketplace comes as federal health officials are focusing intensely on faltering exchanges in two other states, Maryland and Massachusetts.
This month, the board of the Maryland Health Connection became the first in the nation to decide to replace most of its exchange with different technology. But Maryland did not obtain required federal approval before its vote. Federal officials remain uncertain whether the state exchange has the capacity to correct its problems and have not indicated whether they will give Maryland the $40 to $50 million it says it needs to make the switch.
Massachusetts was in the vanguard of insurance exchanges, opening its own years before the 2010 federal health-care law. But the commonwealth’s insurance marketplace developed severe technical problems as it tried to make adjustments to interact with the federal system.
Taken together, the federal uneasiness about these and other failing state insurance exchanges is emerging now that the federal Web site, HealthCare.gov, is largely functional, attracting unexpectedly large numbers of people in the final weeks of the first sign-up period, which just ended. So far, about 8 million Americans have enrolled through the federal and state marketplaces.
The fate of these state-run exchanges has significance both politically and for consumers.
When the Affordable Care Act was enacted, the law’s authors envisioned that virtually every state would build its own exchange, for people who cannot get affordable insurance through a job and for small businesses. Only 14 states and the District have created exchanges. In the remaining three dozen states, Republican governors and legislators, as part of the intense GOP opposition to the law, have left their residents to rely on the federal insurance marketplace, which opened for business in October.
Some of the state-run marketplaces have prospered, including California’s, Connecticut’s and Kentucky’s. But others have been failures, placing a political stain on Democratic statehouses that were among the most enthusiastic in embracing the federal health-care law. In addition to the three states that are currently the focal point of administration officials, exchanges have faltered in a few other places, including Hawaii and Minnesota.
In each of the defective state exchanges, consumers have encountered a variety of obstacles in trying to sign up. Oregon’s consumers have been the only ones who have had to resort entirely to cumbersome paper applications because its Web site has never worked for individual sign-ups, despite nearly $250 million in federal funds spent to set up the exchange.
Just under 64,000 residents have enrolled in private health plans there. In becoming the first state to migrate to the federal insurance marketplace, Oregon is trying to make it easier for more people to sign up for health coverage in the future. But the switch also introduces new uncertainties to an already chaotic environment.
It is unclear, for example, whether people who have just chosen health plans through Cover Oregon will need to sign up a second time in the federal system for their new coverage to continue beyond this year. Nor is it clear whether insurers in Cover Oregon will switch to the federal marketplace, or whether the state will preserve some of the approaches its exchange has employed with enrollment assisters and insurance agents.
As in Maryland, Oregon is led by a Democratic governor, John Kitzhaber, who has been an outspoken proponent of the federal health-care law. The state has, in general, been a leader in innovative policies to promote access to health care and other social services.
“It makes a lot of sense for Oregon to rely on federal technology that is working well today,” said Joel Ario, a health-care consultant and former Obama administration health official in charge of insurance exchanges. “But the bigger question is what this means for Oregon’s leadership role on Medicaid reform and other Kitzhaber initiatives” to control health-care costs.
Republicans immediately capitalized on the imminent closing. Rep. Greg Walden (R-Ore.) lambasted the state exchange as “the worst financial failure in information technology in state history — and it was completely avoidable.”
It has been increasingly clear in recent months that Cover Oregon was failing. The exchange hemorrhaged staff, including an executive director, acting director and, just this week, its chief operating officer. It is currently run by a consultant whom the governor hired to assess what was going wrong.
Another consultant’s analysis for Cover Oregon recently concluded that it would cost $4 million to $6 million to move to the federal insurance marketplace, a fraction of the expense of refurbishing the exchange’s existing technology.
According to the officials, who spoke on the condition of anonymity about discussions that have not been made public, leaders of the federal Centers for Medicare and Medicaid Services, the agency overseeing the insurance marketplaces, advised Oregon officials that they did not believe the state had the ability to repair its own exchange.
The two sides have been negotiating the details of the transition, including exactly how much help the federal government will furnish. The negotiations are expected to conclude in a series of meetings in Washington early next week between federal health officials and exchange representatives from Oregon, Maryland, and Massachusetts.
On Thursday, a technology working group for Cover Oregon reached an informal consensus to recommend to the governing board that it join the federal insurance marketplace. A spokeswoman for Cover Oregon, Ariane Holm, disputed that the decision is final, saying “the Cover Oregon board is the only group with authority to make decisions about next steps.”
Aaron Albright, a spokesman for the Centers for Medicare and Medicaid Services, said the agency is “committed to working closely with states to support their efforts in implementing a marketplace that works best for their consumers. ”
Jason Millman contributed to this report.
Oregon Health Insurance Exchange
Given the monumental technical problems that the Oregon exchange has experienced over the past six months, HHS allowed the state-run exchange to add an additional 30 days to their open enrollment window. Open enrollment in Oregon is now scheduled to end on April 30. All applicants have access to this extension – it is not limited to people who begin their enrollment by March 31, as is generally the case with extensions in the rest of the country.
And following months of efforts to fix the troubled website, Cover Oregon’s board voted on April 25 to switch to using Healthcare.govrather than continue to try to repair the existing site. The Cover Oregon website will still exist but will redirect visitors to Healthcare.gov. The state will be using a partnership model, working together with HHS, with the state retaining some functions and Healthcare.gov being utilized to enroll people in private plans through the exchange.
The Cover Oregon website has been largely regarded as a technological disaster, and full online enrollment still is not available on the site. But even so, by late April, Cover Oregon had enrolled about 70,000 people in private plans, and another 172,000 in Medicaid – a total enrollment of about 242,000 people.
In addition to the exchange enrollments, 123,000 people had enrolled in Medicaid directly through the state by mid-February, a number that was continuing to grow (Medicaid enrollment goes year-round – there is no deadline to apply for Medicaid).
On February 18, four and a half months after open enrollment began, Cover Oregon’s website was finally functional enough for insurance agents and navigators to be able to process enrollments start to finish online. Although the site is still not yet available for the general public to enroll online, the fact that electronic enrollment is possible at all is a huge improvement after months of relying on paper applications. Oregon lawmakers are calling for an investigation into what went wrong with the exchange and how federal funds were spent along the way, further intensifying the pressure on Cover Oregon’s managers and IT team.
Despite the fact that Cover Oregon was the only exchange relying solely on paper applications for the first four months of open enrollment, its total enrollment numbers are around the middle of the road when compared with enrollment in other states – all of which have been using much more efficient online applications for months.
Virtually all of the existing 2013 individual policies in Oregon were eligible for renewal into 2014. Moda Health Plan Inc. and PacificSource Health Plans allowed existing policies to extend until the end of March. And seven carriers allowed 2013 policies to be renewed until the end of 2014: Regence BlueCross BlueShield of Oregon, Kaiser Foundation Health Plan of the Northwest, Providence Health Plan, LifeWise Health Plan of Oregon, Health Net Health Plan of Oregon Inc., Time Insurance Co. and John Alden Life Insurance Co. The renewal of 2013 plans into 2014 gave many Oregon residents in the individual market some breathing room as they wait for Cover Oregon’s website to improve.
The Oregon Medical Insurance Pool – a state run high risk pool – closed at the end of December, but the state implemented atemporary medical insurance program that automatically covered risk pool members who were not able to enroll in an exchange plan with a January 1 effective date. The temporary plan remained in force until March 31, but ceased operation at that point. Insureds who were still covered under the temporary program lost their coverage at the end of March, but the risk pool had been working closely with members to get them transitioned to new policies, so presumably there were very few people still on the temporary program at that point.
The Oregon legislature authorized a state-run health insurance exchange in 2011, and the exchange developed a formal business plan, which the Legislature approved in February 2012 as a final go-ahead for the exchange. The U.S. Department of Health and Human Services (HHS) gave conditional approval to Cover Oregon in December 2012. The exchange has a 2014 budget of $105.7 million, which will be covered with federal grant money, and $62.4 million budget in 2015 according to a Cover Oregon spokesperson.
Cover Oregon is overseen by a nine-member board of directors, two of which are non-voting members. The board receives input from the Individual and Employer Consumer Advisory Committee. The 19-member committee holds monthly meetings, which are open to the public. The Consumer Advisory Committee was mandated by the legislation that established the state’s exchange. Committee members are selected by the board and must include individuals or employers who will use the exchange, individuals who will enroll in state medical assistance through the exchange, minority groups, and representatives of organizations that will people purchase insurance through the exchange. All geographic areas of the state must be represented.
Cover Oregon is acting as “active purchaser,” meaning it limits the number of health insurers that can participate in the exchange. Participating insurers are required to offer a bronze, silver and gold plan and have the option to offer additional plans.
In July 2013, the Oregon Department of Insurance approved rates for insurance policies that will be offered through Cover Oregon. Individuals can choose from among 110 options from 11 carriers, while small groups have 73 options from eight carriers.
According to Kaiser’s State Health Facts, about 17 percent of Oregon’s under-65 population is uninsured. Cover Oregon officials expect about 237,000 people to purchase health insurance through the exchange in 2014.
Contact Portland Benefits Group:
More Oregon health insurance exchange links
State Exchange Profile: Oregon
The Henry J. Kaiser Family Foundation overview of Oregon’s progress toward creating a state health insurance exchange.
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